等离子前列腺剜除术治疗大体积前列腺增生的疗效分析

Curative effect of plasmakinetic enucleation of prostate in the treatment of large volume prostate

目的探讨经尿道双极等离子前列腺剜除术（PKEP）治疗大体积（〉80mL）良性前列腺增生的临床效果。方法选取本院泌尿外科2012年5月至2015年1月收治的80例大体积良性前列腺增生患者进行回顾性分析，根据患者手术方式分为PKEP组37例，经尿道前列腺双极电切术组（TUPKP）43例，对两组患者的围手术期指标、术后随访结果进行比较分析。结果PKEP组的膀胱冲洗时间（20．5±6．7）min、手术出血量（120．5±44．9）mL、尿管留置时间（4．4±1．9）d、术后住院时间（5．2±1．8）d均显著的低于TUPKP组，前列腺切除质量（63．2±21．5）g显著高于TUPKP组（P〈0．05），手术时间比较差异无统计学意义（P〉0．05）。术后PKEP组的Qmax（22．4±4．7）mL／s显著高于TUPKP组（19．5±4．0）mL/s（P〈0．05）。术前、后两组患者的PSA值比较差异无统计学意义（P〉0．05），术后两组患者的PSA值较术前均显著降低（P〈0．05）。PKEP组的术后并发症率（62．16％）显著的低于TUPKP组（86．05％），且差异具有统计学意义（P〈0．05）。结论PKEP治疗大体积良性前列腺增生与TUPKP均具有较好的临床效果，其具有术中出血量少、术后恢复快、术后并发症率更低的特点。

Objectives To evaluate the clinical effect of transurethral plasmakinetic enucleation of the prostate （PKEP） in treatment of large volume benign prostatic hyperplasia（BPH） （ 〉 80mL）. Methods The clinical date of 80 patients with large volume BPH in the hospital from May 2012 to January 2015 were analyzed retrospectively. All patients were divided into PKEP group （n = 37） and transurethral bipolar plasma kinetic prostatectomy （TUPKP group ） （n = 43 ） according to surgical ways. Perioperative indices, postoperative follow - up results of two groups were compared and analysed. Results Bladder washing time （20.5 ± 6.7 ） min, blood loss （ 120.5 ± 44.9 ） mL, indwell- ing catheter time （4.4 ± 1.9） d, postoperative hospitalization （5.2 ± 1.8） d in PKEP group were significantly lower than in TUPKP group and resection of the prostate weight （63.2 ± 21.5 ） g was significantly higher than TUPKP group （ P 〈 0.05 ） , there was no statistically significant difference in operation time of the two groups （ P 〉 0.05 ）. Qmax （22.4 ± 4.7） mL/s in PKEP group was significantly higher than that in TUPKP group （ 19.5 ± 4.0 ） mL/s （ P 〈 0.05 ）. There was no significant difference in PSA values between the two groups before and after operation （ P 〉 0.05 ）, and the PSA values of the two groups were significantly decreased （ P 〈 0.05 ）. The postoperative complication rate （62.16%） in the PKRP group was significantly lower than that in the TUPKP group （86.05%） and the difference was statistically significant （ P 〈 0.05 ）. Conclusions PKEP has good clinical effect in the treatment of large volume BPH and TUPKP, it has the advantages of less bleeding, quick recovery and low complications.