TUERP与TKRP治疗大体积BPH的安全性和疗效比较

Comparison of clinical efficacy and safety between TUERP and TKRP for treatment of large-volume BPH patients

目的:比较经尿道双极等离子前列腺剜除术(transurethral enucleative resection of prostate,TUERP)与经尿道双极等离子前列腺电切术(transurethral plasma kinetic resection of the prostate,TKRP)治疗大体积BPH的安全性和疗效。方法:回顾性分析96例大体积BPH(前列腺体积>70ml)患者的临床资料:60例行TUERP,36例行TKRP。所有患者手术前均行直肠指诊、经直肠前列腺彩超、尿流动力学检查及相关实验室检查,进行IPSS及QOL评分,就两种手术方式中前列腺切除重量、手术时间、术中出血量、留置导尿管时间、并发症、术后住院时间进行对比,同时就两组患者术前和术后IPSS、生活质量评分(quality of life score,QOL)、术后1个月的最大尿流率(Qmax)进行对比。结果:术前两组患者一般情况比较差异无统计学意义(P>0.05);术后两组患者IPSS、QOL、Qmax(术后1个月)明显改善,与术前比较差异有统计学意义(P<0.01),但组间比较差异无统计学意义(P>0.05)。TUERP组术中出血量较少,其手术时间、留置导尿管时间、术后住院时间明显小于TKRP组(P<0.05),前列腺切除重量,TUERP组明显高于TKRP组(P<0.05)。结论:TUERP组与TKRP组对治疗大体积BPH疗效相同,TUERP对大体积BPH患者更安全。

Objective ： To compare the efficacy and safety between transurethral enucleative resection of prostate （TUERP） and transurethral plasma kinetic resection of the prostate （TKRP） for treatment of large-volume BPH patients （volume〉70 ml）. Method：A total of 96 elderly BPH patients with large volume prostate were involved in this study. Their surgical procedures were analyzed retrospectively. All patients received digital examination of rectum, B-ultrasound examination, urodynamic examination and laboratory examination. IPSS, quality of life （QOL） score, and Qmax （1 month post-operation ） were recorded and compared between TUERP group and TKRP group. Operation time, resected prostate weight, catheterization time, intraoperative blood loss, complications, hospital stay were recorded. Result.. Sixty patients underwent TUERP and 36 patients underwent TKRP. Preoperative factors showed no significant differences between two groups （P〉0.05）. IPSS, QOL and Qmax of tWO groups improved after the operation （P〈0.01）, which showed no significant differences between two groups （P〉0.05）. The data of operation time, mean catheterization time and hospital stay were significantly shorter in TUERP than in TKRP （P〈0.05）. Intraoperative blood loss was less in TUERP group than in TKRP group. Average resected prostate weight was more in TUERP group than in TKRP group. Conclusion.. The effect of TUERP is similar to TKRP, but TUERP is safer than TKRP for the elderly BPH patients with large volume prostate.