不同手术方式对老年良性前列腺增生症患者疗效及血清PSA水平的影响

Effect of different operation methods on curative effect and serum PSA level in elderly patients with benign prostatic hyperplasia

目的探讨经尿道前列腺电切术(TURP)与经尿道前列腺等离子双极电切术(TKRP)对老年良性前列腺增生症(BPH)患者临床疗效及血清前列腺特异性抗原(PSA)水平的影响。方法 2014年6月至2015年12月选取本院收治的84例BPH患者为研究对象,根据随机数字表将患者分为观察组及对照组各42例,对照组应用TURP术治疗,观察组应用TKRP术治疗,对比分析两组患者手术成功率、术后复发率、手术疗效及治疗前后血清PSA水平变化。结果观察组手术成功率高于对照组,而尿潴留发生率、术后复发率低于对照组(P<0.05)。观察组术中出血、手术时间、膀胱冲洗时间、导管留置时间及住院时间少于对照组,而术后疼痛评分低于对照组(P<0.05)。观察组术后国际前列腺症状评分(IPSS)低于对照组(P<0.05),术后最大尿流率(Qmax)高于对照组(P<0.05),生活质量评分(QOL)高于对照组(P<0.05),残余尿流量(RUV)少于对照组(P<0.05)。观察组术后血清PSA水平显著低于对照组(P<0.05)。结论 TKRP术具有微创优势,能有效提高BPH患者手术成功率,同时能有效抑制患者PSA释放,有利于患者远期预后。

Objective To evaluate the impact of the levels of serum prostate-specific antigen（ PSA） and efficacy of transurethral resection（ TURP） and Transurethral plasma bipolar TURP（ TKRP） in elderly patients with benign prostatic hyperplasia. Methods 84 patients with BPH were divided into observation group（ n = 42）and control group（ n = 42） from June 2014 to December 2015. The control group were treated with TURP,observation group were treated with TKRP. The surgical success rate,recurrence rate,surgery and the levels of PSA before and after treatment of two groups were analyzed. Results The surgical success rate of observation group were higher than control groups（ P〈0. 05）,while the incidence of urinary retention,recurrence rate were lower than the control group（ P〈0. 05）. The blood loss,operative time,bladder irrigation time,catheter time and hospital stay of observation group were shorter than the control group（ P〈0. 05）. The international prostate symptom score（ IPSS） after treatment of observation group were lower than the control group（ P〈0. 05）,the maximum flow rate（ Qmax）,quality of life（ QOL） score were higher than control group（ P〈0. 05）,the residual urine flow（ RUV） was lower than the control group（ P〈0. 05）. The serum levels of PSA after surgery was significantly lower than the control group（ P〈0. 05）. Conclusions TKRP minimally invasive surgery has advantages,can effectively improve the success rate of surgery in patients with BPH,and can effectively inhibit the release of patients PSA,and is conducive to long-term prognosis.