治疗高危前列腺增生两种手术方法的疗效比较

Comparing Two Surgical Treatments for BPH Patients at High Risk Period

目的:探讨手术治疗高危前列腺增生的最佳方法。方法:高危BPH患者67例,分成经尿道腔内手术39例和传统开放手术28例两组。术后3个月随访,根据IPSS评分、最大尿流率、并发症和住院时间等,比较两组的治疗效果。结果:经尿道前列腺部分电切术39例,术后IPSS评分(9±7),住院时间(7±3)d,并发症发生率0.51%,耻骨上前列腺摘除术28例,术后IPSS评分(10±8),住院时间(16±5)d,并发症发生率3.21%,手术疗效两种术式差异无显著性意义(P>0.05),而术后住院时间、并发症发生率,腔内组明显低于开放组(P<0.05)。结论:经尿道前列腺部分电切术治疗高危前列腺增生的效果理想,具有手术时间短、出血少、创面小、恢复快,并发症少等优点。耻骨上前列腺摘除术创伤较大,但切除腺体彻底,是一切前列腺手术的基础,可作为腔内手术失败后的备选治疗方案,适宜在广大基层医院及初学者间开展。

Objective： To investigate the best surgical treatment for BPH patients at high risk period.Method： 67 BPH patients at high risk were divided into two groups.39 were from transurethral intracavity resectiom and 28 were from traditional open resection.and compared the treatment effects acording to the IPSS.Scores Qmax scores complications and hospital stays.Result： The IPPS score（9±7）,hospital stay（10±8）incidence of complication is,of 39 BPH patients from transurethral partly resection of the prostate,and the compare group was IPSS（10±8）,（10±5）,and no significance between the two groups was observed（P〉0.05）.but the transurethral resection group was obviously lower than the open resection group at the aspects of hospital stays and incidence of complications（P〈0.05）.Conclusion： The transurethral partly resection of prostate is a good treatment for the BPH patients at high risk,it has the advantages of shorter operation time,less bleading early resumption and satisfactory results,the prostatectomy is more trauma,but can totally cut the prostate is the foundamental operation of prostatectomies,it can be chosed if the TURP is failure and it is suitable to be developed in the matrical hospital and the beginners.