经尿道前列腺等离子剜除术与电切术治疗良性前列腺增生的疗效比较

Comparison of the curative effect of transurethral plasma kinetic enucleation of prostate and transurethral resection of prostate on benign prostatic hyperplasia

目的：比较经尿道前列腺等离子剜除术（TUPKEP）与经尿道前列腺电切术（TURP）治疗良性前列腺增生（BPH）的疗效。方法回顾性分析手术治疗的 BPH 患者的临床资料，按治疗方法不同分为两组， TUPKEP 组60例，TURP 组72例，比较两种术式的临床效果。结果TUPKEP 组手术时间、术中出血量分别为（51．3±5．9）min、（131．7±9．2）mL，均显著优于 TURP 组的（62．5±7．4）min、（174．2±10．5）mL（t ＝9．48、24.48，均 P ＜0．05）；TUPKEP 组前列腺切除量[（62．4±7．0）g]明显多于 TURP 组[（45．9±6．1）g]，差异有统计学意义（t ＝14．47，P ＜0．05）；TUPKEP 组术后并发症发生率为1．7％（1／60），显著低于 TURP 组的12．5％（9／72），差异有统计学意义（χ2＝5．50，P ＜0．05）。TUPKEP 组术后住院日、膀胱冲洗时间、导尿管留置时间分别为（4．3±1．0）d、（1．2±0．5）d、（2．6±0．3）d，均短于 TURP 组的（6．2±0．9）d、（2．3±0．9）d、（4．8±0.2）d，差异均有统计学意义（t ＝11．48、8．44、50．27，均 P ＜0．05）；两组手术前后最大尿流率（Qmax）、残余尿量（RUV）、前列腺功能（IPSS）以及生活质量（QOL）均得到明显改善，差异均有统计学意义（TURP 组：t ＝2.46、18．49、2．55、4．37，TUPKEP 组：t ＝2．88、17．59、2．64、3．94，均 P ＜0．05）；两组患者之间术后 Qmax、RUV、IPSS 评分及 QOL 评分差异均无统计学意义（t ＝0．24、0．50、0．56、0．94，均 P ＞0．05）。结论TUPKEP 治疗BPH 的临床疗效肯定，能解除患者排尿困难症状，提高患者的生活质量，且术后并发症发生率低，值得临床推广。

Objective To compare the clinical efficacy between transurethral plasma kinetic enucleation of prostate（TUPKEP）and transurethral resection of prostate（TURP）on benign prostatic hyperplasia（BPH）.Methods The clinical data of patients with BPH were retrospectively analyzed.The clinical results of 72 cases of TURP and 60 cases of TUPKEP were selected.Results The operation time,the amount of bleeding of the TUPKEP group were （51.3 ±5.9）min,（131.7 ±9.2）mL,which were significantly better than those of the TURP group [（62.5 ± 7.4）min,（174.2 ±10.5）mL]（t =9.48,24.48,all P 〈0.05）.The amount of prostate resection in the TUPKEP group[（62.4 ±7.0）g]was significantly higher than that in the TURP group[（45.9 ±6.1 ）g],the difference was statistically significant（t =14.47,P 〈0.05）.The incidence rate of complication in the TUPKEP group was 1.7%（1 /60）,which was significantly lower than that of the TURP group 12.5%（9 /72）,the difference was statistically significant（χ2 =5.50,P 〈0.05）.The postoperative hospitalization time,bladder irrigation time,catheter indwelling time of the TUPKEP group were （4.3 ±1.0）d,（1.2 ±0.5）d,（2.6 ±0.3）d,which were shorter than those of the TURP group [（6.2 ±0.9）d,（2.3 ±0.9）d,（4.8 ±0.2）d],the differences were statistically significant（t =11.48, 8.44,50.27,all P 〈0.05）.The maximum urinary flow rate（Qmax）,residual urine volume（RUV）,prostate function （IPSS）and quality of life（QOL）were significantly improved in the two groups before and after operation,the differ-ences were statistically significant（TURP group：t =2.46,18.49,2.55,4.37;TUPKEP group：t =2.88,17.59,2.64, 3.94;all P 〈0.05）.But there were no significant differences in Qmax,RUV,IPSS score and QOL score between the two groups after surgery（t =0.24,0.50,0.56,0.94,all P 〉0.05）.Conclusion The clinical efficacy of TUPKEP in the treatment of BPH is positive,it can relieve the symptoms of patients with difficulty in urination,improve the quality of life of patients,and the incidence of postoperative complications is low,it is worthy of clinical application.