经尿道前列腺剜除术与电切术治疗良性前列腺增生的效果观察

Comparison of surgical efficacies of transurethal enucleation of prostate with transurethal resection of prostate

目的通过回顾性分析临床资料，比较单极电切进行经尿道前列腺剜除术与前列腺电切术的优劣。方法统计2010、2011年施行前列腺剜除术77例，2009年施行前列腺电切术27例。将其分为剜除术组和电切术组，每组数据依据前列腺质量分为≥60g组和〈60g组。比较每组手术所用时间、出血量、切除前列腺组织量。结果≥60g组：剜除术患者53例，前列腺质量（88．5±9．2）g，手术时间为（91．5±8．8）min，出血量为（110．0±16．4）ml，切除前列腺组织质量为（48．0±4．6）g；电切术患者12例，前列腺质量为（107．0±15．3）g，手术时间为（118．3±20．2）min，出血量为（193．3±22．3）ml，切除前列腺组织质量为（58．4±5．4）g。两组出血量比较差异有统计学意义（P=0．011），而前列腺质量、手术时间、切除前列腺组织质量比较差异均无统计学意义（P值分别为0．255、0．083、0．320）。〈60g组：剜除术患者24例，前列腺质量为（43．1±3．2）g，手术时间为（62．7±6．8）rain，出血量为（56±5）ml，切除前列腺组织质量（26．3±2．4）g；电切术患者15例，前列腺质量为（36．8±3．4）g，手术时间为（69．3±6．2）min，出血量为（110±20）ml，切除前列腺组织质量为（23．6±2．1）g。〈60g组，剜除术与电切术比较，差异均无统计学意义（前列腺体积：P=0．072；手术时间：P=0．431；出血量：P=0．082；切除前列腺组织：P=0．291）。结论应用单极电切术，对于较大前列腺（≥60g）患者，应用剜除术比电切术有更少的出血量，随着术者经验的丰富、手术技术的熟练，剜除术可取代电切术治疗较大前列腺；〈60g前列腺患者，剜除术与电切术无明显差异，术者可根据经验及熟练程度选择术式。

Objective To compare the surgical effects of transurethal enucleation of prostate （TUEP） with transurethal resection of prostate （ TURP ） by a retrospective analysis of clinical data. Methods The patients in this study were divided into the groups of TUEP （enrolled in 2010 and 2011, n = 77 ） and TURP （ enrolled in 2009, n = 27 ） with prostate larger than 60 g and smaller than 60 g respectively. Comparisons were made between the two groups in operation time, blood loss volume and weight of resected prostate. Results In the group of patients with prostate larger than 60 g, there was no significant difference in prostate weight （（88.5± 16.4 ） ml vs. （ 193.3 ± P = 0. 011 ） between the two groups. In the group of patients with prostate smaller than 60 g, there was no significant difference in prostate weight （ （ 43. 1 ±. （69. 3 ± min,P =0. 431 ） ,blood loss （ （56 ± 5） ml vs. （110± of resected prostate （（26.3 ±6 ±2. 1） g, P = O. 291 ） between the TUEP （24 patients） and the TURP （ 15 patients） groups. Conclusion Compared with TURP, TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g. With the improvement of surgeon＇ s experience and development of operation techniques, TURP will be replaced by TUEP. In the treatment of patients with prostate smaller than 60 g, the operation modality can be chosen by the surgeon based on his exoerience and oroficiencv.