良性前列腺增生症4种手术方法的疗效比较研究

A comparative study on 4 different surgical treatments of benign prostate hyperplasia

目的研究经膀胱前列腺摘除术(经膀胱手术),保留尿道前列腺切除术(保留尿道手术),经尿道前列腺等离子双极电切术(PKRP),经尿道选择性绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)的安全性及疗效。方法比较4种术式在治疗轻、中、重度BPH术中出血量及手术时间;比较4种术式膀胱冲洗时间、留置导尿管时间、术后常见并发症及平均手术费用。结果PKRP及PVP治疗轻、中度BPH,手术时间短,出血量少,术后恢复时间短,但费用高。治疗重度BPH,开放手术时间短,出血量与PKRP相当,术后恢复时间长,费用较低。结论4种手术方式都能有效治疗BPH,应该根据患者年龄、身体情况、BPH程度及经济状况,选择相对适合的手术治疗方法,使BPH患者获得安全、有效、及费用最低的治疗。

Objective To compare the differences of safety and effect among 4 surgical methods, namely trans-bladder prostatectomy, urethra reservation prostatectomy, PKRP and PVP. Method All patients were divided into three groups （mild, moderate and severe） according to their severity. The bleeding volume and operating time during operation, bladder irrigation time, catheter indwelling time, the complications, and the costs were compared among these 4 methods. Result The mild and moderate patients were treated by PKRP or PVP with shorter operation time, less bleeding volume and more rapid recovery but higher costs. The severe patients were treated by opening surgery with shorter operating time, the same bleeding volume, longer recovery time and lower costs compared with PKRP. Conclusion All the 4 methods are effective for treating BPH. How to make the relative right choice （safe, effective, stable and economic） is based on the age, health situation, BPH severity and the economic condition of the patient.