双极等离子前列腺剜除术与电切术治疗前列腺增生症的随机对照研究

A randomized comparative study on plasmakinetic enucleation and plasmakinetic resection of prostate in treatment of benign prostatic hyperplasia

目的探讨经尿道前列腺等离子电切术(PKRP)和经尿道前列腺等离子剜除术(PKEP)治疗前列腺增生症(BPH)的安全性和有效性。方法选取60例符合纳入标准的BPH患者随机分为两组,一组30例行PKEP(剜除组),另一组30例行PKRP(电切组)。比较两组术前、术中、术后指标和3月随访指标并进行统计学分析。结果两组一般情况相似,无统计学差异(P>0.05)。两组手术时间、手术中转开放、术中失血输血、电切综合征(TURS)、术后尿失禁发生率、再次留置尿管、尿道狭窄发生率无统计学差异(P>0.05)。剜除组术后膀胱冲洗时间、导尿管留置时间、术后住院时间均短于电切组(P<0.05),切除组织重量大于电切组(P<0.05),术后膀胱刺激征、包膜穿孔及膀胱损伤发生率低于电切组(P<0.05)。两组术后随访3个月最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PRV)无统计学差异(P>0.05)。结论 PKRP和PKEP治疗BPH均安全有效。在相同手术时间内PKEP切除组织效率和术后恢复方面优于PKRP。

Objective To explore the effectiveness and safety of transurethral plasmakinetic resection of prostate（ PKRP） and transurethral plasmakinetic enucleation of prostate（ PKEP） in treatment of benign prostatic hyperplasia. Methods A total of 60 patients with standard benign prostate hyperplasia（ BPH） were randomly divided into two groups,30 cases in group A were applied with PKRP,and 30 cases in group B were applied with PKEP. The preoperative,intraoperative and postoperative parameters were compared between these 2 groups and followed- up for 3 months for statistical analysis. Results The conditions of patients in these 2 groups were generally similar,and the differnce was not statistically significant（ P〉0. 05）. The difference in operating time,convertion to open surgery,transfusion for intraoperative blood loss,TURS,incidence of urinary incontinence,urinary tube replacement and urethral stricture between these 2 groups was not statistically significant（ P〉0. 05）.The bladder douche time,catheter indwelling time,postoperative hospitalization time in PKEP group were shorter than those of PKRP group（ P〈0. 05）. The weight of resected specimens in PKEP group was greater than that of PKRP group（ P〈0. 05）. The incidence rates of capsular perforation and bladder injury and postoperative bladder irritation in PKEP group were lower than those of PKRP group（ P〈0. 05）. The difference in Qmax,IPSS,QOL and PRV between these 2 groups in postoperative follow- up period of 3 months was not statisticallysignificant（ P〉0. 05）.Conclusion The application of PKRP or PKEP in treatment of BPH is safe and effective. The operating time,efficiency and duration for postoperative rehabilitation of PKEP are more efficient and shorter than those of PKRP.