经尿道简化剜除法治疗良性前列腺增生症的对比研究

Comparison of transurethral simplied plasmakinetic enucleation and transurethral plasmakinetic enucleation of prostate in the treatment of benign prostatic hyperplasia

目的比较简化剜除术与经尿道等离子前列腺剜除术(PKEP)治疗前列腺增生症的近期疗效。方法将具有手术指征的167例前列腺增生症(BPH)患者随机分为两组,分别为简化剜除组和剜除组,监测、记录患者手术时间、切出量和术前术后最大尿流率改善,术中术后并发症情况。结果术中切除腺体重量,半剜除组(33.3±9.6)g与剜除组(35.3±11.2)g(P>0.05),差异无统计学意义;术后3个月,两组最大尿流率均比术前得到明显改善(P>0.05),改善率差异无统计学意义。结论经尿道前列腺等离子简化剜除术治疗BPH具有与经尿道等离子前列腺剜除术(PKEP)相近的近期疗效,但手术时间明显缩短,在保证疗效情况下,可以降低手术时间,降低手术风险,且操作较简单,尤其适合初学者。

Objective To compare the clinical effects and safety of transurethral simplified plasmakinetic enucleation of prostate and transurethral plasmakinetic enucleation of prostate in the treatment of benign prostatic hyperplasia （BPH）. Methods 167 patients with BPH who had surgical indications were randomized into two groups： simplify PKEP group and PKEP group. The preoperative international prostate symptom score （ IPSS） ,the quality of life （ QOL） ,quantity of maximum flow rate （Qmax） , the operation time ,weight of resected prostate were recorded. Three months after the operation, the complications and improvement of maximum flow rate （Qmax） were observed. Results The weight of resected prostate had no significant difference between the two groups （P 〉 0.05）. but there was significant difference in operation time between the two groups （P 〈 0.05） . In three months after operation. both two groups had significant improvement in Qmax and there was no significant difference in the improvement rate of Qmax （P 〉 0.05）. Conclusion Simplify plasmakinetic enucleation of prostate should be as effective and safety as transurethral plasmakinetic enucleation of prostate in the treatment of symptomatic BPR. Furthermore it cost less operation time than PKEP and predigest the operation process , so it should be an ideal minimal invasive treatment for BPR especially for beginners.