经尿道整体剜除联合手术刨削器与前列腺剜除术治疗大体积前列腺增生症的对比研究

摘要

目的 探讨经尿道剜除联合手术刨削器治疗大体积(＞80 mL)前列腺增生症(BPH)的临床效果.方法 将60例大体积BPH随机分为2组,刨削器组和剜除组(PKEP组),每组30例,刨削器组采用经尿道整体剜除前列腺,完整剜除后推入膀胱,更换手术刨削器,将剜除的腺体粉碎取出;PKEP组采用常规经尿道前列腺剜除术.结果 60例均顺利完成手术.刨削器组手术时间较PKEP组短[(48.5±17.3) min vs.(65.8±15.5) min,t=4.079,P=0.000],术中出血量较PKEP组少[(51.8±14.6)mL vs.(87.6±23.5) mL,t=7.088,P=0.000].两组腺体切除体积、术后膀胱冲洗时间、术后住院天数无统计学差异(P＞0.05).两组术后3月IPSS、Qmax、残余尿均较术前明显改善(P＜0.05),但两组间无统计学差异(P＞0.05).结论 经尿道腔内整体剜除联合手术刨削器治疗大体积BPH,手术时间更短,术中出血量少,术后效果与前列腺剜除术相当.%Objective To investigate the efficacy of transurethral enucleation plus operative rotating cutter for large size benign prostatic hyperplasia (BPH).Methods A total of 60 cases of large BPH were randomly divided into 2 groups:one group received transurethral enucleation plus operative rotating cutter (n =30,rotating cutter group);the other group received conventional plasmakinetic enucleation of prostate (n =30,PKEP group).Results Satisfactory surgical results were obtained in all cases.The operation time of the rotating cutter group was shorter than that of the PKEP group (48.5±17.3) min vs.(65.8± 15.5) min,(t =4.079,P=0.000).Blood loss of rotating cutter group was less than that of PKEP group (51.8± 14.6) mL vs.(87.6 ± 23.5) mL,(t =7.088,P =0.000).There were no significant differences in postoperative IPSS,Qmax and re sidual urine between the two groups (P＞0.05).Postoperative variables of these were significant different compared with preoperative ones (P＜0.05).Conclusion Transurethral enucleation plus operative rotating cutter for large BPH takes shorter operation time and causes less blood loss than PKEP,and the postoperative effect is almost the same as PKEP.