两种经尿道等离子术式治疗良性前列腺增生症临床对比研究

Clinical efficacy of two kinds of transurethral prostate resection in the treatment of benign prostatic hyperplasia

目的探讨经尿道等离子电切术和经尿道等离子剜除术式治疗良性前列腺增生症临床疗效及安全性差异。方法研究对象选取我院近年来收治良性前列腺增生症患者共110例,采用随机数字表法分为A组(55例)和B组(55例),分别采用经尿道等离子电切和剜除术式治疗;比较两组患者围手术期临床指标、手术前后前列腺症状评分(IPSS)、最大尿流率(Q_(max))、残余尿量(PVR)、生活质量评分(QoL)及围手术期并发症发生率等。结果 B组患者围手术期临床指标均显著优于A组,差异有统计学意义(P<0.05);两组患者术后IPSS评分、Q_(max)及PVR均显著优于术前,差异有统计学意义(P<0.05);但两组患者术后IPSS评分、Q_(max)及PVR比较差异无统计学意义(P>0.05);B组患者术后QoL评分均显著优于A组和术前,差异有统计学意义(P<0.05)。B组患者术中包膜穿孔、术后尿道膀胱刺激征及二次尿道导尿管留置发生率均显著低于A组,差异有统计学意义(P<0.05)。两组患者术后尿失禁发生率比较差异无统计学意义(P>0.05)。结论相较于经尿道等离子电切术式,经尿道等离子剜除术式治疗良性前列腺增生症可显著缩短手术时间,减少术中创伤,并有助于提高生活质量和降低围手术期并发症发生风险。

Objective To investigate the clinical effects and safety of transurethral resection of the plasma and transurethral plasma kinetic enucleation of the prostate in the treatment of benign prostatic hyperplasia. Methods Total of 110 patients with benign prostatic hyperplasia were recruited in our hospital and randomly divided into two groups such as group A （60 patients who underwent with transurethral resection of the plasma） and group B （60 patients who underwent with transurethral plasma kinetic enucleation of the prostate）;The clinical indicators in peri-operation period, the prostate symptom score （IPSS）, maximum urinary flow rate （Qmax）, residual urine volume （PVR）, quality of life score （QoL）, quality of life score （PVR） before and after surgery and the incidence of perioperative complications of two groups were comparatively analyzed. Results The clinical indicators in peri-operation period of group B were significantly better than that of A group （P〈0.05）. The IPSS score, levels of Qmax and PVR after surgery of both groups were all significantly better than those before surgery （P〈0.05）. There were no significant differences in IPSS score, levels of Qmax and PVR after surgery between 2 groups （P〈0.05）. The QoL score after surgery of group B was significantly better than that of A group and that before surgery （P〈0.05）. The incidence of capsule perforation in operation, postoperative urethral bladder irritation sign, and the secondary urethral catheter of group B was significantly better than those of group A （P〈0.05）. There was no significant difference in the incidence of postoperative urinary incontinence between two groups （P〈0.05）. Conclusion Compared nbsp;with transurethral resection of the plasma, transurethral plasma kinetic enucleation of the prostate in the treatment of benign prostatic hyperplasia can efficiently shorten the operation time, reduce the degree of trauma and improve the quality of life and decrease the risk of complications in peri-operative period.