摘要
目的比较腹腔镜下耻骨后保留尿道前列腺切除术和经尿道前列腺电切术(TuRP)治疗大体积前列腺增生的临床效果。方法回顾性分析128例大体积良性前列腺增生患者的II缶床资料及随访情况。其中行TURP患者72例(TURP组),行腹腔镜下耻骨后保留尿道前列腺切除术患者56例(腹腔镜组)。比较两组的手术时间、术中出血量、切除腺体质量、膀胱冲洗时间、带管时间、住院时间、住院费用、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(MRF)、残余尿(RUV)等指标。结果腹腔镜组术后膀胱冲洗时间(0d)、带管时间[(2.3±0.6)d]、住院时间[(4.2±0.5)d]均较TURP组[(2.8±1.2)、(5.2±1.5)、(7.5±0.5)d]少,切除腺体质量[(100.2±25.4)g]较TURP组[(85.6±15.5)g]多,组间比较差异有统计学意义(P〈0.05);两组手术时间、术中出血量、住院费用比较差异无统计学意义(P〉0.05)。两组术后3、6个月IPSS、QOL、RUV和MRF与术前比较差异均有统计学意义[腹腔镜组:(9.1±3.4)、(7.5±2.5)分比(27.5±5.8)分,(1.8±1.1)、(1.6±0.8)分比(5.5±0.5)分,(26.5±11.5)、(22.4±12.6)ml比(145.0±48.0)ml.(17.6±8.4)、(20.2±5.4)ml/s比(8.3±3.5)ml/s;TURP组:(9.2±3.8)、(7.8±2.2)分比(28.5±5.4)分,(1.9±1.2)、(1.7±0.6)分比(5.0±0.5)分,(28.5±12.9)、(23.0±11.7)ml比(155.0±47.0)ml,(17.8±9.2)、(19.8±4.5)ml/s比(7.2±3.2)ml/s](P〈0.01),但组间比较差异无统计学意义(P〉0.05)。结论两种术式疗效均佳,行腹腔镜下耻骨后保留尿道前列腺切除术患者术后不需膀胱冲洗,带管时间短,住院时间少,恢复快。
Objective To compare the clinical effect between retropubic extraperitoneal laparoseopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH). Methods The clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively. Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopie prostatectomy with prostatic urethra preservation (laparoseopic group). The operation time, blood loss, gland mass excision,bladder washing time, catheterization time, hospital stay, hospital cost, international prostate symptoms score (IPSS) and quality of life questionnaires (QOL), maximum flow rate (MFR), residual urine volume ( RUV ) were compared between two groups. Results The bladder washing time, catheterization time,hospital stay in laparoscopic group were less than those in TURP group[ 0 d vs. ( 2.8 ± 1.2 ) d, ( 2.3 ± 0.6) d vs. (5.2 ± 1.5 ) d, (4.2 ± 0.5 ) d vs. (7.5 ± 0.5 ) d l, gland mass excision in laparoscopic group was more than that in TURP group [ (100.2 ± 25.4 ) g vs. (85.6 ± 15.5 ) g ], there were significant differences between two groups (P 〈 0.05 ). There was no significant difference in the operation time, blood loss, hospital cost between two groups (P 〉 0.05). There were significant differences in IPSS, QOL, RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group: (9.1 ± 3.4 ), (7.5 ± 2.5 ) scores vs. (27.5 ± 5.8 ) scores, ( 1.8 ± 1.1 ), ( 1.6 ± 0.8 ) scores vs. (5.5 ±0.5) scores, (26.5 ± 11.5), (22.4 ± 12.6) ml vs. (145.0 ±48.0) ml, (17.6 ± 8.4), (20.2 ± 5.4) ml/s vs. (8.3 ± 3.5) ml/s;TURP group: (9.2 ± 3.8), (7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores, ( 1.9 ± 1.2 ), ( 1.7 ± 0.6) scores vs. (5.0 ±0.5 ) scores, (28.5 ± 12.9 ), (23.0 ± 11.7 ) ml vs. ( 155.0 ± 47.0) ml, ( 17.8 ± 9.2), ( 19.8 ± 4.5 ) ml/s vs. (7.2 ± 3.2) ml/s ] (P 〈 0.01 ), but there was no significant difference between two groups (P 〉 0.05). Conclusions The clinical effect of two microtrauma surgery are good. Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery, shorter hospital stay, less complications, no bladder washing.
出处
《中国医师进修杂志》
2012年第5期30-33,共4页
Chinese Journal of Postgraduates of Medicine
关键词
前列腺增生
腹腔镜
经尿道前列腺切除术
Prostatic hyperplasia
Laparoscopies
Transurethral resection of prostate