经尿道等离子前列腺剜除术与前列腺切除术的对比研究

Comparative Study on Transurethral Plasmakinetic Enucleation of Prostate and Transurethral Resection of Prostate

目的比较经尿道等离子前列腺切除术与经尿道等离子前列腺剜除术治疗良性前列腺增生症的疗效及安全性比较。方法通过两组手术切除腺体的方式不同,比较两组各自术前术后IPSS、QOL、尿流率、残余尿等指标的差异,比较两组手术术中前列腺切除量与术中出血之间的关系,比较两组手术术后IPSS、QOL、最大尿流率、残余尿的差异以及术后拔除导尿管、膀胱冲洗时间的差异,以充分了解和评估两种手术方式的优缺点。结果将60例符合实验条件的前列腺增生患者分为两组,各30例,其中,PKRP、PKEP组各自术后IPSS评分、QOL评分、最大尿流率与术前比较差异有统计学意义(P<0.01)。两组切除组织量、术中出血量比较差异有统计学差异(P<0.05)。两组手术术后最大尿流率、膀胱冲洗时间、拔除导尿管时间比较差异有统计学差异(P<0.05)。两组手术手术时间,术后IPSS、QOL、残余尿以及术后并发症比较差异无统计学意义(P>0.05)。结论两种手术方法在治疗良性前列腺增生方面均有良好效果,但经尿道等离子前列腺剜除术在术中切除增生腺体的重量、术中出血量以及术后最大尿流率、术后膀胱冲洗时间、术后拔除导尿管时间优于经尿道等离子前列腺切除术,在安全性方面更好,值得推广应用。

Objective To compare the curative effect and the safety of transurethral plasmakinetic enucleation of prostate and transurethral resection of prostate in the treatment of BPH （Benign Prostate Hyperplasia）. Methods The differences of the two differ-ent gland removal surgeries in terms of preoperative and postoperative IPSS, QOL, urine flow rate and residual urine were procured, the relationship between the removal volume of prostate and blood loss during the surgery was confirmed, and the differences of postop-erative IPSS, QOL, maximum urine low rate, residual urine, the time of the removal of the catheter and the time of bladder irrigation between the two surgeries were compared, so as to fully understand and estimate the advantages and disadvantages of the ways of sur-gery. Results 60 patients with BPH who met the experimental conditions were divided into two groups, 30 patients in each group. It was founded that the differences between preoperative and postoperative IPSS, QOL, maximum urine flow rate of Group PKRP and Group PKEP was statistically significant （P〈0. 01）. The difference in the removal volume of prostate and blood loss during the surgery was statistically significant （P〈0. 05）. The difference of postoperative maximum urine flow rate, the time of the removal of the catheter and the time of bladder irrigation between the two groups were statistically significant （P〈0. 05）. The difference of operation time, postoperative IPSS, QOL, residual urine, and complications between the groups was not statistically significant （P〉0. 05）. Conclu-sion The two surgical methods have good results in the treatment of benign prostatic hyperplasia. By comparison, transurethral plas-makinetic enucleation of prostate earns its advantage over transurethral resection of prostate in the removal volume of prostate and blood loss during the surgery, postoperative maximum urine flow rate, the time of the removal of the catheter and the time of bladder irriga-tion, which is safer and bears more popularizing value.