经尿道前列腺电切术与经尿道双极等离子电切术治疗良性前列腺增生的疗效比较

Transurethral resection of prostate versus bipolar plasma kinetic resection of the prostate: A comparison of their effects on the treatment of 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电切术(PKRP)治疗良性前列腺增生的疗效。方法:选择2006年10月～2011年11月在我院泌尿外科接受手术治疗的良性前列腺增生患者800例,其中接受TURP的有320例,接受PKRP的有480例,比较两组手术情况、术后症状改善情况及并发症情况。结果:两组患者的年龄、前列腺质量及尿潴留病史、膀胱结石、高血压史的患病率差异无统计学意义(P>0.05);PKRP组的手术时间、术中出血量均少于TURP组(P<0.05);两组治疗6个月后IPSS、QOL、Qmax均明显改善,与治疗前比较差异显著(P<0.05),但两组间比较差异并无统计学意义(P>0.05);TURP组的电切综合征(TURS)、暂时性尿失禁及尿道狭窄的发生率高于PKRP组,两组间差异有统计学意义(P<0.05)。结论:经尿道前列腺电切术和经尿道双极等离子电切术均是治疗良性前列腺增生的有效手段,但经尿道双极等离子电切术手术时间短、术中出血量少,电切综合征发生率低,并发症少,安全性更高,是较为理想的治疗方式。

Objectives： The main objective of this study was to compare the efficacy and safety between transurethral resec-tion of prostate （TURP） and bipolar plasma kinetic resection of the prostate （PKRP） for benign prostatic hyporplasia （BPH）. Methods： In this study, we selected 800 BPH patients who were treated in the Department of urology of our hospital from Octo-ber, 2006 to November, 2011. All the patients were divided into two groups according to different operation method, namely, TURP group and PKRP group. Then the operation conditions, the symptom improvements and the side - effects were compared between the two groups. Results： There was no significant difference in preoperative factors between the two groups. The opera- tive time and intraoperative bleeding were significant less in PKRP than in TURP group. Six months postoperatively, IPSS, QOL and Qmax were significantly improved in both two groups, but there was no significant difference in symptom improvement between the two groups. The incidence rate of TRUS, uroclepsia, urethrostenosis were remarkablly higher in TURP group than in PKRP group. Conclusion： PKRP and TURP have similar efficacy in the treatment of BPH, but PKRP is safer than TURP, presenting less intraoperative bleeding, low incidence of TURS and complications. Therefore, PKRP is a better treatment option for BPH.