两种经尿道前列腺切除术治疗良性前列腺增生症的疗效比较

Comparative study on transurethral electroresection of prostate and transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia

目的比较经尿道前列腺电切术(TURP)与经尿道双极等离子前列腺切除术(PKRP)治疗良性前列腺增生症(BPH)的优缺点。方法分别采用TURP(357例)、PKRP(326例)治疗BPH,观察两组患者手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOLS)、最大尿流率(MFR)、残余尿(RUV)的改善情况以及术后并发症的发生情况。结果两种术式患者术后IPSS、QOLS、MFR、RUV均得到显著改善,组间差异无显著性(P>0.05)。对Ⅰ～Ⅱ度前列腺增生,两组术式手术时间无差异;对Ⅲ度前列腺增生,TURP组手术时间短于PKRP组(P<0.01)。两组术式术中切除前列组织重量、术中出血及术后主要观察指标差异均无显著性。TURP组3例发生电切综合症,2例因前列腺包膜穿孔中转开放手术,而PKRP组无上述情况发生。PKRP组术后并发症少于TURP组。结论TURP及PKRP均为治疗BPH的有效手段,PKRP较之TURP术中更为安全,手术后并发症较少,但手术时间较长。

Objective To study the advantages and disadvantages of transurethral electroreception of prostate （TURP） and transurethral plasma kinetic resection of prostate （PKRP） for the treatment of benign prostatic hyperplasia （BPH）. Methods 683 cases of BPH were treated with the two operative methods： 357 cases with TURP and 326 cases with PKRP. The changes of international prostate symptom score （IPSS）, quality of life scale （QOLS）, the maximum urinary flow rate （MFR）, residual urine volume （RUV） before and after operation and the occurrence of postoperative complications were investigated. Results The IPSS, QOLS, MFR, RUV of the two groups were improved obviously after operation （P〈0.01）. For patients at stage Ⅰ - Ⅱ, there were no differences in the operation time between the two methods; however, the operation time of TURP was shorter than that of PKRP （P 〈 0. 01） for patients at stage Ⅲ. Resected prostate tissue weight, postoperative bleeding, and other leading indicators were not significantly different between the two groups. In the TURP group, 3 cases developed TUR syndromes, 2 cases changed to open surgery when prostatic capsular perforation oeeurred; but no complications occurred in the PKRP group. Conclusion TURP and PKRP are both effective for the treatment of BHP. PKRP is safer than TURP during operation, and fewer patients have complications, but its operation time is longer.