经尿道等离子体双极电切与经尿道普通电切对前列腺增生症的疗效比较

Therapeutic efficacy of bipolar plasmakinetic technique compared with transurethral resection on benign prostate hyperplasia

目的比较经尿道等离子体双极电切术(PKRP)和经尿道前列腺电切术(TURP)的安全性和疗效。方法对400例有症状的前列腺增生症(BPH)患者随机分成两组,分别行PKRP和TURP术。结果200例PKRP手术者,前列腺症状评分(IPSS)从术前的27·1±4·5分下降至术后6个月的11·3分±3·4分(P<0·01),最大尿流率(Qmax)由6·1ml/s±2·4ml/s上升至18·6ml/s±3·5ml/s(P<0·01),剩余尿量(RU)由102·3ml±43·3ml降至22·6ml±16·3ml(P<0·01)。TURP组200例,IPSS从术前的26·9分±4·2分下降至术后6个月的10·8分±3·6分(P<0·01),最大尿流率由5·7ml/s±2·4ml/s上升至19·1ml/s±3·7ml/s(P<0·01),剩余尿(RU)由102·3ml±43·3ml降至22·6ml±16·3ml(P<0·01)。两组比较差异无统计学意义(P>0·05)。平均留置导尿管时间PKRP组31·5h,TURP组61·5h,差异有统计学意义(P<0·01)。术后阳萎发生率:PKRP组14·3%,TURP组15·2%(P>0·05)。PKRP组术中无大出血及经尿道前列腺电切综合征(TURS)发生,无一例需要输血。TURP组5例发生TURS,输血18例。结论PKRP能达到与TURP完全相同的治疗效果,且并发症少,价格相对较低,近期效果满意。

Objective To evaluate the effect and safety of transurethral prostatectomy with the bipolar plasmakinetic technique （PKRP） compared with the transurethral resection （TURP） in the treatment of benign prostate hyperplasia （ BPH ）. Method Four hundred BPH patients with matched lesions were divided into 2 groups： 200 patients, aged 74. 1 （58- 91 ）, underwent transurethral prostatectomy with PKRP, and 200 patients, aged 73.8 （ 56 - 90）, underwent TURP. Result In the PKRP group the average IPSS decreased from 27.1±4.5 preoperatively to 11.3 ±3.4 postoperatively 6 months after （ P 〈 0.01 ）, the. average maximum flow-rate Q（max） increased from 6.1 ±2.4 ml/s preoperatively to 18.6±3.5 ml/s postoperatively （P 〈 0. 01 ）, and the average residual urine （RU） reduced from 102. 3±43. 3 ml preoperatively to 22.6 ±16.3 ml after the operation （P 〈0.01 ）. However in the TURP group the average IPSS decreased from26.9 ± 4.2 preoperatively to 10.8 ±3.6 6 months after the operation （ P 〈 0.01 ）, the Q （max） increased from 5.7 ±2.4 ml/s preoperatively to 19.1±3.7 ml/s postoperatively （ P 〈 0.01 ）, and the average RU decreased from 102.3±43.3 ml preoperatively to 22.6±16.3 ml after the operation （P 〈 0.01 ）. There were no significant differences in these parameters between these 2 groups （ all P 〉 0.05 ）. The average catheter retention time was 31.5h in the PKRP, significantly shorter than that in the TURP group （61.5 hours, P 〈0.01 ）. The incidence rate of post-operational asynodia in the PKRP group was 14.3% , not significantly different from that in the TURP group （15.2% , P 〉0.05）. During the operation no hemorrhea or transurethral resection syndrome （TURS） occurred in the PKRP group, however, there were 5 cases of TURS and 18 cases of blood transfusion in the TURP group. Condusion PKRP has the same therapeutic efficacy as TURP on BPH. Moreover, it was more cheaper and with lower complication than TURP.