经尿道前列腺钬激光剜除术联合膀胱小切口与经尿道双极等离子前列腺剜除术治疗高危大体积前列腺增生的比较研究

Comparative study of Holep combined treatment of bladder small incision and PKERP for high-risk large volume prostate hyperplasia

目的比较经尿道前列腺钬激光剜除术(Holep)联合膀胱小切口与经尿道双极等离子前列腺剜除术(PKERP)两种方法治疗高危大体积良性前列腺增生(BPH)的安全性及有效性。方法分析Holep联合膀胱小切口治疗高危大体积BPH患者110例与采用PKERP术治疗高危大体积BPH患者108例临床资料,对两组的手术时间、术中出血量、电切综合征(TURS)、术后冲洗时间、留置导尿时间、术后国际前列腺症状评分(IPSS)和生活质量指数(QOL)评分、最大尿流率(Qmax)、膀胱残余尿量(PVR)、术后尿道狭窄和尿路刺激症进行比较。结果两组患者术前一般资料差异无统计学意义(P>0.05),术后IPSS、QOL、Qmax、PVR与术前比较均有统计学意义(P<0.01),但两组间比较差异无统计学意义(P>0.05);手术时间及术中出血量Holep组明显小于PKERP组,术后冲洗时间、留置导尿时间、TURS、尿道狭窄和尿路刺激征两组比较差异无统计学意义。结论Holep联合膀胱小切口与PKERP均是高危大体积良性前列腺增生的有效手术方法,但Holep联合膀胱小切口术中出血量少,手术时间短,对于高危大体积BPH患者安全性更高。

【Objective】To assess the clinical efficacy and safety of the treatment about Holep joint bladder small incision and PKERP for large volume of high-risk benign prostatic hyperplasia.【Methods】The surgical procedures of 110 cases with Holep joint bladder small incision and 108 cases with PKERP. The operative time, blood loss,transurethral resection syndrome（TURS）, washing time after surgery, catheterization time, international prostate symptom score（IPSS）, quality of life（QOL）, maximun flow rate（Qmax）, post void residua（PVR） and postoperative urethral stricture, urinary tract irritation comparison were compared.【Results】The were no significant differences of preoperative factors between two groups（P〉0.05）, the IPSS, QOL, Qmax, PVR before and after surgery were significant differences（P〈0.01）, but no significant between the two groups difference（P〈0.05）; operative time and blood loss was significantly less than PKERP, washing time after surgery, catheterization time, TURS, urethral stricture and urinary tract irritation was no significant difference between the two groups. 【Conclusions】The two surgical are effective to the treatment of benign prostatic hyperplasia, but Holep joint bladder small incision is higher security in less blood loss, shorter operative time for large volume of high-risk BPH patients.