经尿道前列腺等离子双极电切和经尿道前列腺电切治疗良性前列腺增生的临床结果比较

Comparison of the results of transurethral plasmakinetic resection versus transurethral resection of the prostate for benign prostatic hyperplasia

目的比较经尿道前列腺等离子双极电切术(PKRP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的临床疗效及安全性。方法PKRP组78例,TURP组78例,比较2组手术时间、术中出血量,术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)及并发症发生率。结果PKRP组手术时间、术中出血量、术后2个月内暂时性尿失禁发生率、术后4周内继发性出血及3个月内尿道狭窄发生率分别为(64±21)min,(247±84)ml,26．9％(21／78),1．3％(1／78)和2．6％(2／78),TURP组分别为(78±18)min,(432±132)ml,48．7％(38／78),10．3％(8／78)和12．8％(10／78),2组比较差异均有统计学意义(P<0．05)。2组均未发生电切综合征(TURS)。PKRP组术后IPSS为4．6±1．2,QOL为1．1±0．8,Qmax为(26．1±4．6)ml／s; TURP组分别为4．8 4±1．1、1．3±0．8、(25．3．4±4．2)ml／s;均较术前明显改善(P<0．01),但组间差异无统计学意义。结论PKRP与TURP比较,治疗BPH疗效相近,但安全性更好,是治疗BPH的理想方法。

Objective To compare the clinical efficacy and safety of transurethral plasmakinetic resection of prostate （PKRP） and transurethral resection of prostate （TURP） for benign prostatic hyperplasia （BPH）. Methods Two groups of BPH patients （78 patients in each group） were treated by PKRP and TURP,respectively. The clinical efficacy and safety indices were reviewed and compared for both intraand inter-groups. Results In PKRP group,the operative time,intraoperative bleeding, the rates of postoperative temporary urinary incontinence （ within 2 months） , secondary hemorrhage （ within 4 weeks ） , and urethral stricture （within 3 months ） were （ 64 ±21 ） min, （ 247 ± 84 ） ml, 26.9% （ 21/78 ）, 1.3% （ 1/78 ） and 2.6% （2/78） , respectively ; while in TURP group, these parameters were （ 78±18 ） min, （ 432 ± 132 ） ml, 48.7% （38/78） , 10. 3% （ 8/78 ） and 12. 8% （ 10/78 ） , respectively; there were significant differences between the 2 groups （ P 〈 0.05 ）. No transurethral resection syndrome （TURS） occurred in both groups. In PKRP group, the International Prostate Symptom Score （IPSS） ,quality of life （QOL） and Qmax were 4.6 ±1.2,1.1±0.8 and （26.1 ±4.6） mL/s,respectively; while in TURP group, these parameters were 4.8 ±1.1, 1.3±0.8 and （25.3 ± 4.2）ml/s, respehively; these parameters were significantly improved after both procedures （P 〈 0.01 ） ;but there was no significant difference in the above parameters between the 2 groups （P 〉0.05 ）. Conclusions PKRP and TURP have similar efficacy in the treatment of BPH, but PKRP is safer than TURP. Thus,PKRP is a better treatment option for BPH.