经尿道等离子前列腺电切术和剜除术治疗前列腺增生的临床疗效比较

目的对比分析经尿道双极等离子前列腺电切术(PKRP)和前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的疗效及并发症。方法回顾性分析2008年1月～2010年12月收治的BPH患者303例,PKRP组143例,年龄(73±13.4)岁,前列腺体积(76.5±22.5)ml;PKEP组160例,年龄(74±11.6)岁,前列腺体积(74.3±26.5)ml。比较两组患者手术时间、术中出血量、切除组织量及手术并发症发生率及疗效。结果两组术后残余尿量、IPS-S评分、生活质量评分、最大尿流率术后与术前比较,差异均有统计学意义(P<0.05),两组术后比较差异均无统计学意义(P>0.05)。两组切除组织量、术中出血量比较差异均有统计学意义(P<0.05)。两组手术时间、术后暂时性尿失禁发生率、3个月内尿道狭窄发生率比较差异均无统计学意义(P>0.05)。结论两种术式治疗BPH均有满意疗效,但PKEP在术中出血量及切除组织量方面更有优势,值得推广应用。

Objective To compare the efficacy and complications between bipolar plasmakinetic resection of prostate and bipolar plasmakinetic enucleation of prostate for benign prostatic hyperplasia（BPH）. Methods 303 cases of BPH were divided into 2 groups, 143 cases aged （73±13.4） years with prostate volume of （76.5±22.5）ml underwent PKRP; 160 cases aged （74±11.6） years with prostate volume of （74.3±26.5）ml underwent PKEP. The operative time,resected tissue weighed, blood loss, catheterization time, hospital stay and complications were compared between the 2groups. Results In 2 group, the postoperative RUV, IPSS, QOL and Qmax were significantly improved after both procedures（P0.05）, but there was no significant difference in the above parameters between the 2 groups（P0.05）.Blood loss, resected tissue weighed were significant differences between the 2 groups（P0.05）. The operative time, contemporary incontinence and 3 monthes after operation urethral stricture were no significant differences between the 2 groups（P0.05）. Conclusion The 2 surgical procedures have significant efficacy in the treatment of BPH. But the blood loss and incidences of contemporary incontinence of PKER have more superiority than those of PKRP, so PKER deserves our application.