经尿道等离子双极电切术治疗良性前列腺增生的疗效评价

Therapeutic evaluation of transurethral resection of the prostate with plasmakinetic energy for the treatment of benign prostatic hyperplasia

目的评价经尿道等离子双极电切术(PKRP)治疗良性前列腺增生的安全性和近期疗效。方法采用PKRP治疗良性前列腺增生(BPH)患者220例,观察平均手术时间、术中出血量、术后持续膀胱冲洗时间、留置尿管时间、住院时间、手术并发症,记录术前及术后6个月、12个月随访国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、剩余尿量(PVR)等指标并进行统计学分析。结果PKRP平均手术时间(47.7±23.3)min,术中出血量(56.4±39.6)mL,持续膀胱冲洗时间(3.8±0.8)d,留置尿管时间(5.0±2.1)d,住院时间(6.2±2.4)d,术后随访6个月、12个月IPSS、QOL、Qmax、PRV与术前比较差异均有统计学意义(P<0.05),术后手术近期疗效满意,无严重并发症。结论PKRP治疗BPH具有术中出血少、视野清晰、术后恢复快、并发症少及易于掌握的优点,有可能成为替代传统TURP的新术式。

Objective To evaluate the safety and short-term efficacy of transurethral resection of the prostate with plasmakinetic energy （PKRP） for the treatment of benign prostatic hyperplasia （BPH）. Methods 220 cases of large volume BPH were treated with PKRP. The mean operative time, blood loss, the mean bladder irrigating time, catheration time, hospital stay and operative complications were observed. The indices such as IPSS, QOL, Qmax and PVR were recorded and statistically analyzed peroperatively, and at 6 and 12 months postoperatively. Results The mean operative time was （47.7±23.3）min, the blood loss （56.4±39.6）mL, mean bladder irrigating time （3.8±0.8） days, the catheration time （5.0±2.1） days, and the hospital stay （6. 2± 2. 4） days. At 6 and 12 months postoperatively, IPSS, QOL, Qmax and PRV were significantly different compared with those preoperatively （ P 〈 0. 05）. There were few complications and great patients satisfaction with the short-term post-operative results. Conclusion The advantages of PKRP include less bleeding, clear field of view during operation, quick recovery after operation and it is easy to learn. PKRP may be an alternative to TURP.