经尿道前列腺双极等离子电切术和前列腺电切术治疗良性前列腺增生的效果
| 作者: |
1夏宗禹,
1王琴,
1刘胜
1 重庆三峡中心医院泌尿外科，重庆 404000 |
| 通讯: |
刘胜
Email: 346451287@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.11.016 |
摘要
目的：探讨经尿道前列腺双极等离子电切术(plasmakinetic resection prostate，PKRP)和前列腺电切术(transurethral resection of prostate，TURP)治疗良性前列腺增生(benign prostatic hyperplasia，BPH)的手术效果以及并发症情况，为临床术式选择提供参考。方法：纳入重庆三峡中心医院泌尿外科2017年6月至2018年6月期间收治的98例BPH患者，采用计算机随机分组法分为PKRP组和TURP组，两组各49例。均有同组资深泌尿外科医师操作，手术相关护理也均一致。结合术后3个月随访，比较两组手术基本指标、住院情况、国际前列腺症状评分(International Prostate Symptom Score，IPSS)、尿动力学检查指标以及相关并发症情况。结果：两组患者均成功完成手术和术后3个月随访，PKRP组术中出血量、术后膀胱冲洗时间、导管留置时间均低于TURP组，差异有统计学意义(P<0.05)，手术时间差异无统计学意义(P>0.05)；两组术前IPSS评分和残余尿(residual urine volume，RUV)、最大尿流率(Qmax)比较差异均无统计学意义(P>0.05)，术后3个月IPSS评分、RUV均有明显下降，Qmax明显升高，差异有统计学意义(P<0.05)，PKRP组术后3个月IPSS评分和尿动力学指标较TURP组均明显改善，差异有统计学意义(P<0.05)；两组暂时性尿失禁、尿频尿痛、膀胱颈挛缩发生率比较差异均无统计学意义(P>0.05)，PKRP组继发性出血、勃起功能障碍发生率及总并发症率均低于TURP组，差异有统计学意义(P<0.05)。结论：PKRP治疗BPH的手术效果不仅同“金标准”TURP相近，还具有术中出血量少、术后膀胱冲洗和导管留置时间短、并发症少等优点，是一种疗效显著、安全性高的有效术式。
关键词：
良性前列腺增生；经尿道前列腺双极等离子电切术；经尿道前列腺电切术；前列腺症状；尿动力学；并发症
Efficacy of transurethral bipolar plasma resection of prostate and transurethral resection of prostate in the treatment of benign prostatic hyperplasia
CorrespondingAuthor: LIU Sheng Email: 346451287@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.11.016
Abstract
Objective: To investigate the effect and complications of transurethral plasma resection of prostate (PKRP) and transurethral resection of prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). Methods: A total of 98 patients with BPH admitted to our urology department from June 2017 to June 2018 were randomly divided into two groups: a PKRP group and a TURP group, 49 cases in each group. All of them were operated by the same group of senior urologists, and the operation-related nursing was the same. Combined with the follow-up of 3 months after operation, the basic indexes of operation, hospitalization, International Prostate Symptom Score (IPSS), urodynamic indexes and related complications were compared between the two groups. Results: Both groups successfully completed the operation and followed up for 3 months after operation. The bleeding volume, bladder irrigation time and catheter indwelling time in PKRP group were lower than those in TURP group, the difference was significant (P<0.05), and there was no significant difference in operation time (P>0.05). There was no significant difference in IPSS score, RUV of residual urine and Qmax of maximum urine flow rate between the two groups before operation (P>0.05), and 3 after operation (P>0.05). The monthly IPSS score and residual urine RUV decreased significantly, and the maximum urinary flow rate (Qmax) increased significantly (P<0.05). IPSS score and urodynamic indexes in PKRP group were significantly improved than those in TURP group at 3 months after operation (P<0.05). There were no significant differences in the incidence of temporary urinary incontinence, frequency/pain and bladder neck contracture between the two groups (P>0.05). The incidence of secondary bleeding, erectile dysfunction and total complications in PKRP group were lower than those in TURP group (P<0.05). Conclusion: The effect of PKRP on BPH is not only similar to the “gold standard” TURP, but also has the advantages of less bleeding during operation, shorter time for bladder irrigation and catheter indwelling after operation, and fewer complications. PKRP is an effective method with remarkable curative effect and high safety.
Keywords：
benign prostatic hyperplasia; transurethral bipolar plasma resection of the prostate; transurethral resection of the prostate; prostate symptoms; urodynamics; complications