三种经尿道手术治疗前列腺增生症的疗效比较

Comparative Study of Three Kinds of Transurethral Treatment Methods for Benign Prostatic Hyperlasia

目的评价经尿道前列腺电切术(TURP)、经尿道前列腺电气化术(TUVP)和经尿道前列腺等离子气化电切术(PKRP)治疗前列腺增生症(BPH)的疗效。方法回顾分析TURP、TUVP、PKRP治疗172例BPH患者的疗效、并发症、住院费用、主要手术成本等。结果三种术式患者手术前后前列腺症状评分(I-PSS)、生活质量评分(QOL)、最大尿流率(Qmax)均得到显著改善(P<0.01),三组之间相比差异无显著性;三种术式的置管时间及住院时间均相似;TURP组住院期间失血量最多;而手术时间最短,住院费和手术主要成本最低。结论三种腔道手术都是治疗前列腺增生的有效方法,其疗效相似;TUVP或PKRP更适合初学者;考虑成本和住院费因素,TURP仍是三种BPH腔内手术治疗的最佳选择。

[Objective]To evaluate the clinical and cost-effective results of Transurethral vaporisation of the prostate （TUVP）, and transurethral plasma kinetic electrovaporization resection of prostate （PKRP） , with transurethral resection of the prostate （TURP）. [Methods]One hundred seventy two cases of BPH were treated with TURP, TUVP and PKRP respectively. Retrospective study of the treatment effect, complication and cost of hospitalization of the three groups was made . Adverse events were recorded during the hospital stay and at follow-up visits. [Results]Postoperatively, the IPSS, QOL, and Qmax of all the cases were significantly improved（ P 〈0.01）, and there was no significant difference among the three groups. The mean indwelling catheter time and resident time had no significant difference among three kinds of therapies. The average blood loss was maxinum, the average time of operation was shortest, the patient＇s and hospital cost were lowest in the TURP compared with other groups. [Conclusion]Three surgical methods are all effective to treat of BPH. TURP is as effective as TUVP ＆ PKRP for the treatment of symptomatic BPH. TUVP ＆. PKRP are easily handled and safe for beginners. TURP is still the best choice for the treatment of symptomatic BPH considering patient＇s cost and hospital cost among three methods.