经尿道等离子双极电切术治疗前列腺增生症的疗效观察与并发症分析

Clinical effect of PKRP in treatment with benign prostatic hyperplasia and analysis of complications

目的 探讨经尿道前列腺等离子双极电切术治疗良性前列腺增生症的临床效果与安全性.方法 选取本院2011年3月～2013年1月间手术治疗的共200例BPH患者,其中手术方式为经尿道前列腺等离子双极电切术（PKRP）的114例,经尿道前列腺电切术（TURP）的86例,以TURP组为对照,从国际前列腺症状评分（IPSS）、生活质量评分（QOL）、残余尿量（RUV）、最大尿流率（Qmax）四个方面比较两组患者的手术效果,从平均手术时间、术中失血量、尿道前列腺电切综合征（TURS）发生率、平均住院时间四个方面来比较两组患者的治疗效果,对常见并发症如前列腺包膜穿孔、膀胱颈穿孔、术后出血、尿失禁、排尿困难等的发生率进行分析,探讨两种手术方法的安全性.结果 两组的IPSS和QOL评分无显著性差异,而PKRP组的RUV较TURP组明显减少,PKRP组的Qmax较TURP组大,两组间差异均有统计学意义.PKRP组在平均手术时间、术中失血量、TURS发生率及平均住院日方面,都明显优于TURP组,各指标间差异有统计学意义.PKRP组术后各种并发症的发生率较TURP组明显较低.结论 PKRP是目前治疗BPH的安全有效的方法,其整体效果要优于TURP,应大力推广使用.

Objectives To investigate the clinical curative effect and safety of plasma kinetic resection for benign prostatic hyperplasia （BPH）.Methods 200 cases of BPH patients were treated in our hospital during March in 2011 and March in 2013,concluding 114 cases in plasma kinetic resection of the prostate （PKRP） surgery and 86 cases in transurethral resection prostate （TURP） surgery.With TURP group as control,we evaluate the effects of PKRP group from scores of international prostate symptom score（IPSS）,quality of life（QOL）,residual urine volume （RUV）,maximum urinary flow rate （Qmax）.While,evaluate the hospitalization from the average time of operation,blood loss during operation,TURP syndrome as well as the average length of stay.Analyze the incidence of common complications,such as prostatic capsule perforation,bladder neck perforation,postoperative bleeding and urinary incontinence,to discuss the safety of two methods.Results After operation treatment,The IPSS and QOL score of two groups were no significant difference,while RUV in PKRP group was significantly lower than TURP group,Qmax in PKRP group was much farther than that in TURP group.The average time of operation,blood loss during operation,TURP syndrome and the average length of stay have an further advantage in PKRP group,and the differences between the two groups were statistically significant.Conclusions PKRP is a safe and effective method for the treatment of BPH,and the clinical curative effect is superior to TURP,which should be promoted in clinic.