经尿道前列腺电汽化术联合电切术治疗高危前列腺增生症的临床分析

Clinical analysis of TUVP combined with TURP in Treatment of Patients with High-risk Prostatic Hyperplasia

目的探讨经尿道前列腺电汽化术(TUVP)联合经尿道前列腺电切术(TURP)治疗高危前列腺增生的临床疗效及安全性。方法根据入院先后顺序及患者意愿,将93例高危前列腺增生患者分为TUVP+TURP组(n=47)和TURP组(n=46)。两组术前均积极治疗合并症及基础疾病,TURP组行TURP治疗,TUVP+TURP组行TUVP联合TURP治疗。比较两组术前及术后1年的最大尿流率(Qmax)、膀胱残余尿量(RUV)、国际前列腺症状评分(IPSS)及生活质量(QOL)评分,并观察术后不良反应的发生情况。结果两组术后并发症主要包括经尿道电切综合征(TUPS)、继发血尿、尿潴留、暂时性尿失禁和尿路刺激症,TUVP+TURP组并发症总发生率明显低于TURP组,差异有统计学意义(P<0.05)。术后1年,两组Qmax均较术前明显增加,而RUV、IPSS及QOL评分明显降低,差异有统计学意义(P<0.01);组间各指标比较,差异无统计学意义(P>0.05)。结论TUVP联合TURP治疗高危前列腺增生可充分发挥两种术式的优点,减少术后并发症的发生,且安全性较高,值得临床推广应用。

Objective To explore the clinical efficacy and safety of transurethral vaporization of prostate（TUVP）combined with transurethral remove of prostate（TURP）in the treatment of high-risk prostatic hyperplasia.Methods According to the sequences of hospitalization and patients′intentions,93 patients with highrisk prostatic hyperplasia were divided into TUVP＋TURP group（47cases）and TURP group（46cases）.Before operation,complications and basic disease in both groups were positively treated,on which basis TURP group was treated with TURP while TUVP＋TURP group with TUVP combined with TURP.The maximum urinary flow rate（Qmax）,residual urine volume（RUV）,international prostate symptom score（IPSS）and quality of life（QOL）before and 1year after operation were compared between two groups,and the conditions of postoperative adverse responses were recorded.Results Postoperative complications in both groups included transurethral prostate resection syndrome（TUPS）,secondary blood urine,postoperative urinary retention,temporary incontinence and urinary tract irritation,whose rate was evidently higher in TUVP＋TURP group than in TURP group,and the difference was statistically significant（P〈0.05）.One year after operation,Qmax increased markedly in both groups,whereas RUV,IPSS and QOL scores decreased apparently than those before operation（P〈0.01）,but there was no statistically significant difference between two groups（P〈0.05）.Conclusion TUVP combined with TURP can fully exploit their advantages,reduce the rate of complications,and is safer in treating patients with high-risk prostatic hyperplasia.