经尿道双极等离子前列腺剜除术与电切术治疗老年前列腺增生的效果比较

摘要

目的 探讨经尿道双极等离子前列腺剜除术与电切术治疗老年前列腺增生的效果. 方法 选取2016年1～12月我院收治的80例老年前列腺增生病人作为研究对象,随机分为观察组与对照组,每组各40例,观察组采用经尿道双极等离子前列腺剜除术,对照组采用经尿道双极等离子前列腺电切术,比较2组病人手术时间、切除前列腺质量、膀胱冲洗时间、留置尿管时间、术后住院时间以及2组病人术前及术后6个月国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和残余尿量(PVR)的变化. 结果 观察组的手术时间、膀胱冲洗时间、留置尿管时间、术后住院时间均显著少于对照组,切除前列腺质量显著大于对照组,差异均有统计学意义(P＜0.05).术前,2组间IPSS评分Qmax、PVR差异无统计学意义(P＞0.05);术后6个月,2组的IPSS评分均比术前显著降低(P＜0.05),Qmax均显著升高(P＜0.05),PVR均显著降低(P＜0.05),但2组间差异无统计学意义(P＞0.05).观察组的并发症发生率显著低于对照组,差异有统计学意义(P＜0.05). 结论 经尿道双极等离子前列腺剜除术与电切术在改善前列腺增生症状及尿道功能方面具有相似的治疗效果,但剜除术的手术切除率更高、术后恢复更快,是治疗老年前列腺增生的理想方法.%Objective To explore the application effect of transurethral plasmakinetic enucleation of prostate or transurethral bipolar plasmakinetic resection of prostate in the treatment of senile benign prostatic hyperplasia(BPH).Methods Eighty elderly patients with BPH from January to December 2016 in our hospital were randomly divided into the observation group and the control group,with 40 cases in each group.The observation group was treated with transurethral plasmakinetic enucleation of the prostate,the control group was treated with transurethral bipolar plasmakinetic resection of prostate.The operation time,the quality of resected prostate,bladder irrigation time,indwelling catheter time,postoperative hospital stay were compared between the two groups,and the changes of International Prostate Symptom Score (IPSS),maximum urinary flow rate (Q) and residual urine volume (PVR) were compared between the 2 groups before and after operation.Results The operation time,bladder irrigation time,indwelling catheter time,postoperative hospitalization time of the observation group were significantly less than those of the control group,and the quality of resection of the prostate was significantly larger than that of the control group(P＜0.05).There were no significant difference in IPSS score,Qmax and PVR between the two groups before operation (P＞0.05);At 6 months after operation,the IPSS scores and PVR of the two groups were significantly lower and Qmax was significantly higher than those before operation (P＜0.05),but there was no significant difference between the two groups (P＞ 0.05).The complication rate of the observation group was significantly lower than that of the control group(P＜0.05).Conclusions Transurethral enucleation of the prostate and transurethral resection of the prostate have similar therapeutic effect in improving the symptoms of BPH and urethral function,but the enucleation has higher resection rate and faster postoperative recovery,which is an ideal method for the treatment of senile BPH.