经尿道双极等离子前列腺剜除联合等离子电切术治疗良性前列腺增生的临床效果

Clinical effect of transurethral bipolar plasma enucleation of the prostate combined with plasma resection in the treatment of benign prostatic hyperplasia

目的评价经尿道双极等离子前列腺剜除联合等离子电切术与传统经尿道前列腺等离子剜除手术(transurethral plasmakinetic enucleation of the prostate,TPKEP)对良性前列腺增生(benign prostate hyperplasia,BPH)患者手术后的不同治疗效果。方法研究比较贵州医科大学附属肿瘤医院及江苏省宿迁市第一人民医院行经尿道前列腺剜除术治疗的BPH患者86例,其中43例患者采取经尿道双极等离子前列腺剜除联合等离子电切术设为试验组,另外43例患者采用传统经尿道等离子前列腺剜除方式设为对照组,对比术前及术后6个月复查国际前列腺症状评分(International Prostate Symptom Score,IPSS)、最大尿流率(maximum urinary flow rate,Qmax)、残余尿量(residual urine volume,RVU)变化情况;以及术后两组患者拔除尿管后24 h、1周、1个月尿失禁发生情况。结果试验组和对照组术后6个月术后IPSS评分较术前明显降低,Qmax明显高于术前,RVU较术前明显减少,差异均有统计学意义(均P<0.05);试验组和对照组间上述指标差异无统计学意义(P>0.05);试验组患者术后去除尿管后24 h、1周、1个月尿失禁发生与对照组比较明显减少,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联合等离子电切术与TPKEP术比较,不但能同样改善BPH患者排尿症状,还能更好的减少手术后尿失禁发生,具有更好的尿控效果。

Objective To evaluate the different therapeutic effects of transurethral bipolar plasma enucleation of the prostate combined with plasma resection and conventional transurethral plasma prostatectomy(TPKEP)on patients with benign prostatic hypeiplasia(BPH)after operation.Methods Totally 86 cases of BPH treated by transurethral prostatectomy in The First People's Hospital of Suqian and The Afliated Cancer Hospital of Guizhou Medical University were analyzed and compared.43 cases were treated by transurethral bipolar plasma enucleation of the prostate combined with plasma resection,and 43 cases were treated by routine transurethral plasma enucleation.IPSS score,maximum urinary flow rate,residual urine volume were observed before and after operation.Urinary incontinence occurred 24 h,1 week and 1 month after the removal of tirinary catheter.Results The IPSS score,maximum urinary flow rate and residual urine voltime of the patients in the experimental group and the control group after operation were compared with those before operation(P<0.05).No statistical significance between the two groups after operation(P>0.05).Compared with the control group,the incidence of tirinary incontinence in the experimental group 24 h,1 week and 1 month after the removal of tirinary catheter was significantly reduced(P<0.05).Conclusion Compared with conventional transurethral plasma prostatectomy,transurethral bipolar plasma enucleation of the prostate combined with plasma resection can not only improve the urinary symptoms of patients,but also reduce the occurrence of urinary incontinence after operation,and it has better imnary control effect.