经尿道前列腺等离子剜除术临床应用研究

The clinical application research of transurethral plasmakinetic enucleation of prostate

目的探讨经尿道前列腺等离子剜除术治疗良性前列腺增生症(BPH)的临床应用价值。方法 2011年9月至2012年3月采用经尿道前列腺等离子剜除术治疗25例符合手术指征的BPH患者,观察手术时间、术后膀胱冲洗时间、术前及术后残余尿量(PVR)、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)等指标并分析总结。结果所有经尿道前列腺等离子剜除术治疗过程顺利,手术时间40～120 min。术后膀胱冲洗时间(20±1.8)h,术后无继发性出血。与术前相比,术后3个月患者残余尿量明显减少[(115.2±35.5)ml vs(17.6±2.4)ml,P<0.05],最大尿流率明显增加[(5.8±1.6)ml/s vs(24.0±4.2)ml/s,P<0.05],IPSS评分明显好转[(25.3±3.4)分vs(6.2±1.5)分,P<0.05]。结论经尿道前列腺等离子剜除术既保证了微创手术特点,又能达到开放手术的效果,具有出血少、恢复快、安全性高等优点,尤其适用于大体积前列腺。

Objective To investigate the efficacy, safety and short - term outcome of transurethral plasmakinetic enucleation of prostate on symptomatic benign prostatic hyperplasia. Methods We retrospectively reviewed the clinical data of 25 patients in our hospital, who had undergone transurethral plasmakinetic enucleation of prostate from September 2011 to March 2012. The preoperative international prostate symptom score（ IPSS）, Quantity of maximum flow rate（ Qmax）, postvoid residual urine volume（ PVR）, the perioperative operation time, the bladder irrigation time, and hospitalization were recorded. All results were statistically analyzed. Results All the 25 patients were successfully operated under transurethral plasmakinetic enucleation of prostate. No operation was converted to open surgery. The operative time was 40 - 120 minutes, The bladder irrigation time was （20 ± 1.8 ） h. No secondary bleeding occurred after operation. Compared to the pre - operative, PVR was significantly reduced after 3 months （ 17.6 ± 2.4） ml vs （ 115.2 ± 35.5 ） ml （ P 〈 0.05 ）, Qmax was obviously increased （24.0 ± 4.2） ml/s vs （5.8 ± 1.6 ） ml/s （ P 〈 0.05 ）, and IPSS was markedly improved, （ 6.2 ± 1.5 ） vs （ 25.3 ±3.4 ） （ P 〈 0.05 ）. Conclusion Transurethral plasmakinetic enucleation of prostate is an effective treatment option for benign prostatic hyperplasia. It not only has the advantage of minimally invasive surgery, but also can reach the effect of open surgery, providing quick recovery and minimal bleeding. It is also a safe and efficacious option for large volume prostate.