PKERP与PKRP在治疗中重度BPH时腺体切除率的对比分析

Comparative analysis of postoperative gland resection rate of PKERP and PKRP in the treatment of moderate to severe benign prostatic hyperplasia

目的：分析比较经尿道双极等离子腔内前列腺剜除术（PKERP）与经尿道前列腺等离子双极电切术（PKRP）在治疗中重度BPH时的组织切除重量和切除率，评价两种手术方式的组织切除率差别及PKERP的术后临床效果。方法：随机对照研究2011年1～12月采用PKERP及PKRP治疗84例腺体重量超过50g的BPH患者临床资料。对术前B超所测前列腺体积后的估计重量、实际切除重量及手术腺体切除率进行对比分析。结果：84例患者无死亡发生，PKERP术前前列腺估测重量为50．2～135g，平均为79．4g；切除组织重量为43．6～112g，平均为60．7g，平均切除比率为76．5％。PKRP术前前列腺估测重量为52．2～130．2g，平均为77．6g；切除组织重量为28．7～78．1g，平均为38．1g，平均切除比率为54．5％。结果显示切除率与前列腺的估测重量呈正相关。两组患者术前前列腺估测重量比较，差异均无统计学意义（P〉0．05）；两组患者前列腺切除重量及前列腺组织切除率比较，差异均有统计学意义（P〈O．05）。结论lPKERP治疗中重度BPH临床效果显著，并发症低，可以完整切除增生腺体，降低了腺体残留引发的继发性出血和再手术率。

Objective：To analyze Gland resection rate and tissue resection weight of PKERP in the treatment of moderate to severe benign prostatic hyperplasia, to evaluate difference in gland resection rate and postoperative clinical effects for the two methods. Methods：To collect my hospital clinical material of PKERP and PKRP in the treatment of 84 BPH patients whose Glands weighted more than 50 grams during 2011, to make comparative anal ysis of expected prostate volume measured by B ultrasound before surgery, actual resection weight and gland re- section rate. Results： No deaths occurred in 84 BPH patients. In PKERP method： The estimated preoperative weight of the prostate was 50.2-135 g, and average was 79.4 g; The weight of resected tissue was 43.6-112 g,and average was 77.6 g; Average resection rate was 76.5%. In PKRP method： The estimated preoperative weight of the prostate was 52.2 130.2 g, and average was 77.6 g; The weight of resected tissue was 28.7 78.1 g, and average was 38.1 g; Average resection rate was 54.5%. Results show that there was positive correlation between the resection rate and the estimated weight of prostate. The difference in comprison of estimated preoperative weight of the prostate in the two methods was not statistically significant （P〉0. 05）. The difference in comprison of postoperative gland resection rate and tissue resection weigh in the two methods was statistically significant （P〈0.05）. Conclusions： PKERP has significant clinical effect with low incidence of complications in the treatment of moderate to severe benign prostatic hyperplasia, could remove hyperplastic glands completely, and reduce reoperation rate or the possibility of secondary bleeding caused by residual gland.