经尿道等离子前列腺剜除术和电切术治疗前列腺增生的效果比较

Efficacy comparison of clinical between transurethral plasmakinetic enucleation of prostate and transurethral plasmakinetic resection of benign prostate treating prostatic hyperplasia

目的比较经尿道等离子前列腺腔内剜除术（TUPKEP）与经尿道等离子前列腺电切除术（TUPKRP）治疗良性前列腺增生症的效果和安全性。方法选取2009年1月～2012年12月在暨南大学附属第四医院治疗的良性前列腺增生患者146例,分为TUPKEP组和TUPKRP组,每组各73例。比较两组在手术时间、出血量、腺体切除量、膀胱冲洗时间、尿管停留时间、住院天数及术后尿失禁发生率的差异。结果两组最大尿流率（Qmax）、残余尿（PVR）、国际前列腺症状评分（IPSS）和生活质量评分（QOL）及尿失禁发生率差异无统计学意义（P〉0.05）,TUPKEP组在手术时间、术中出血量、术后膀胱冲洗时间、尿管停留时间、住院天数均少于TUPKRP组[分别为（50.2±6.7）min比（61.8±8.2）min;（150.2±18.1）mL比（231.3±22.4）mL;（1.0±0.2）d比（1.9±0.4）d;（1.1±0.2）d比（3.8±0.5）d;（4.1±1.2）d比（6.2±1.6）d],差异有统计学意义（P〈0.05）;TUPKEP组的腺体切除量[（37.2±4.3）g]多于TUPKRP组[（26.8±5.2）g],差异有统计学意义（P〈0.05）。结论 TUPKEP与TUPKRP两种方法治疗BPH的临床效果相近,但是TUPKEP的手术时间、出血量少、膀胱冲洗时间、尿管停留时间及术后住院时间更短,腺体切除更彻底,值得推广和应用。

Objective To compare the efficacy and safety of transurethral plasmakinetic enucleation of prostate（TUPKEP） and transurethral plasmakinetic resection of prostate（TUPKRP） for treating benign prostatic hyperplasia（BPH）.Methods From January 2009 to December 2012, in the Fourth Affiliated Hospital of Ji＇nan University, 146 patients with BPH were divided into TUPKEP group and TUPKEP group, with 73 cases in each group. Parameters including operating time,intraoperative blood loss,resected tissue weight, bladder irrigation time, catheterization time, postoperative hospitalization time and postoperative urinary incontinence rate were compared,while postvoid residua（PVR）, maximum urinary flow rates（Qmax）, international prostate symptom score（IPSS）, quality of life score（QOL） were observed and compared. Results There was no significant difference between two groups in postoperative urinary incontinence rate,PVR, Qmax, IPSS and QQL（P〉0.05）. The operation time, intraoperative blood loss, bladder irrigating time, and postoperative hospitalization time in TUPKEP group were significant shorter than those in TUPKRP group [（50.2±6.7） min vs（61.8±8.2） min;（150.2±18.1） mL vs（231.3±22.4） mL;（1.0±0.2） d vs（1.9±0.4） d;（1.1±0.2） d vs（3.8±0.5） d;（4.1±1.2） d vs（6.2±1.6） d, respectively], the differences were statistically significant（P〈0.05）. The resected tissue weight of prostate in TUPKEP group [（37.2±4.3） g] was more than that in TUPKRP group [（26.8±5.2） g], the difference was statistically significant（P〈0.05）. Conclusion There is no difference in clinical efficiency between two groups, but TUPKEP has advantages in operation time, blood loss, bladder irrigating time, postoperative hospitalization time, and resected tissue weight.