经尿道纽扣式电极等离子剜切术与经尿道前列腺电切术治疗良性前列腺增生的疗效及安全性比较

摘要

Objective To compare the clinical efficacy and safety of transurethral vapor enucleation and resection of prostate with TURis button (TVERP) with those of transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH),and to assess the clinical value of TVERP.Methods A total of 62 patients with BPH selected from October 2011 to June 2012 were randomly divided into two groups.30 patients underwent TVERP and 32 received TURP.The volume of intraoperative bleeding,weight of resected tissues,surgial duration,time to catheter placement,and time to bladder washing were documented.The maximum urine flow rate (Qmax),post-voiding residual urine (PVR),quality of life (QOL),and International Prostate Symptoms Score (IPSS) were assessed.Results There were significant differences in volume of intraoperative bleeding,weight of resected tissues,surgial duration,time to catheter placement,and time to bladder washing between the two groups (P＜0.05).PVR,IPSS,QOL,and Qmax differed significanty after surgical treatment (P＜0.05).There were no significant differences between the two groups in all the indexes after the procedures (P＞0.05).Conclusions Both TVERP and TURP are efficacious in the treatment of BPH.TVERP has the advantage of complete resection of the tissue,less blood loss,and shorter surgical duration.%目的 比较经尿道纽扣式电极等离子剜切术(TVERP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的安全性与手术疗效,评估经尿道纽扣式电极等离子剜切术的临床应用价值.方法 2011年10月至2012年6月共入组62例BPH患者,30例应用经尿道纽扣式电极等离子剜切术治疗,32例行经尿道前列腺电切术治疗.记录两组患者术中出血量、切除组织量、手术时间、留置尿管时间、膀胱冲洗时间.评估术前及术后最大尿流率(Qmax)、残余尿量(PVR)、生活质量评分(QOL)、国际前列腺症状评分(IPSS).结果 两组术中出血量、切除组织量、手术时间、留置尿管时间、膀胱冲洗时间比较差异均有统计学意义(P＜0.05).两组术后Qmax、PVR、QOL、IPSS与术前比较差异均有统计学意义(P＜0.05).两组术后残余尿量、IPSS评分、生活质量评分、最大尿流率比较差异均无统计学意义(P＞0.05).结论 TVERP及TURP治疗BPH效果均显著,TVERP具有切除组织彻底、出血量少、手术时间短的优点.