经尿道等离子体双极电切术治疗良性前列腺增生

Transurethral bipolar plasmakinetic resection for the management of benign prostatic hyperplasia

目的探讨经尿道等离子双极电切的安全性与有效性.方法用经尿道等离子双极电切行前列腺切除(PKRP)56例,前列腺36～110 g,平均(50.3±26.4)g,术后随访1～6个月.结果手术时间25～100 min,平均(56±26) min.切除前列腺组织重量10～89 g,平均(50±22) g.术中出血35～200 ml, 平均(75±49)ml.无电切综合征.术后1、3、6个月随访,最大尿流率(Qmax)由术前(6.7±2.9)ml/s分别上升至(17.4±5.1) ml/s、(20.8±3.9) ml/s、(21.6±4.6)ml/s.国际前列腺症状评(IPSS)分由术前的(23.2±3.8)下降至(6.9±1.7)、(6.1±2.1)、(5.9±1.5).生活质量评分(QOL)由术前的(5.7±1.5)下降至(2.7±0.7)、(2.4±0.5)、(1.9±0.9).3项指标手术前后比较差异均有显著性(P<0.05).结论用等离子双极电切进行PKRP安全有效.

Objective To evaluate the efficacy and safety of transurethral plasmakinetic resection of the prostate （ PKRP）. Methods A total of 56 patients with symptomatic benign prostatic hyperplasia （BPI-I） underwent the PKRP. The weight of the prostate ranged 36 -110 g （mean, 50.3 ± 26.4 g）. All the patients were followed for 1 - 6 months postoperatively. Results The duration of the procedure was 25 - 100 min （mean, 56 ± 26 min） , the weight of resected prostate was 10 - 89 g （mean, 50 - 22 g） , and the intraoperative blood loss, 35 - 200 ml （mean, 75 - 49 ml）. No transurethral resection syndrome occurred. On 1, 3, and 6 postoperative months of follow- up, the peak flow rate （Qmax） increased from 6.7 ± 2.9 ml/s preoperatively to 17.4 ±5.1 ml/s, 20.8 ± 3.9 ml/s, and 21.6 ± 4.6 ml/s, respectively, the international prostate symptom score （IPSS） decreased from 23.2 ± 3.8 preoperatively to 6.9 ±1.7, 6. 1 ±2. 1, and 5.9 ± 1.5, respectively, and the quality of life （QOL） decreased from 5.7 ± 1.5 preoperatively to 2.7± 0.7, 2.4 ± 0.5, and 1.9 ± 0.9, respectively. The differences between pre - and post - operative periods in the three indicators were all statistically significant （P 〈 0.05 ）. Conclusions Transurethral bipolar plasmakinetic resection of the prostate is effective and safe.