经尿道等离子前列腺分区剜除术治疗高危前列腺增生症的临床分析

Clinical analysis of transurethral plasma kinetic enucleation of prostate in treatment of high risk patients with benign prostatic hyperplasia

目的 探讨经尿道前列腺分区剜除术治疗高危前列腺增生患者的临床疗效.方法 经尿道等离子前列腺分区剜除术治疗高危前列腺增生患者89例,对其手术前后前列腺体积、残余尿量、国际前列腺症状评分（IpSS）、生活质量评分（QoL）和最大尿流率（Qmax）等指标进行统计学分析.结果 89例患者均顺利完成手术,术中、术后均无严重并反症发生,手术时间30～110 min,平均45±12.6 min;术中切除前列腺组织净重20～60 g,平均30.6±13.2 g;出血量50～300 mL,平均110±27 mL.平均随访3个月,患者国际前列腺症状评分（IpSS）由21.6±3.9分降至11.8±5.1分,残余尿量由120.2±27.6 mL降至20.2±12.3 mL,最大尿流率由7.1±4.4 mL/s升至14.6±5.2 mL/s,与术前比较有显著性差异（P＜0.05）.结论 经尿道等离子前列腺分区剜除术治疗高危前列腺增生安全、有效.充分的术前准备,以及个体化的手术方案是手术成功的关键.

Objective To evaluate the effects of transurethral plasma kinetic enucleation of prostate in treatment of high risk patients suffered from benign prostatic hyperplasia. Methods Eightynine benign prostatic hyperplasia patients with severe complications were treated with transurethral plasma kinetic enucleation of the prostate. Perioperative prostate volume, residual urine, international prostate symptom score （IPSS）, quality of life （QoL） and maximal flow rate （Qmax） were evaluated. Results Eighty-nine patients were performed the surgical protocol successfully, no severe post- complication was noticed. The operation time was from 30 to 110 min, an average 45±12.6 min. The weight of excision gland ranged from 20 to 60 g, an average 30.6±13.2 g. Blood loss during operation was 50-300 ml, an average 110±26.9 ml. The average follow-up visit time was 3 months. IPSS dropped from 21.6±3.9 to11.8±5.1 （P〈0.05）. RUV decreased from 120.2±27.6 ml to 20.2±12.3 ml （P〈0.05）. The Qmax increased from 7.1±4.4 ml/s to 14.6±5.2 ml/s（P〈0.05）. Conclusion Transuretbral plasma kinetic enucleation of the middle lobe is an effective and safe surgical procedure for the patients with high risk benign prostatic hyperplasia.