大体积BPH患者行TPKEP的疗效及对尿道功能与性功能的影响

Impact of TPKEP in the treatment of benign prostatic hyperplasia with over 80ml volume on efficacy,urethral function and sexual function

目的:探讨大体积BPH患者行经尿道等离子前列腺剜除术(TPKEP)的疗效及对尿道功能与性功能的影响。方法:选取2014年10月~2015年10月收入我院的124例大体积BPH患者,根据随机数字表法分为对照组和观察组,各62例。对照组应用TURP治疗,观察组应用TPKEP治疗。比较两组患者手术相关指标,随访6个月,比较两组患者术前及术后的尿道功能、性功能以及并发症的发生情况。结果:观察组患者手术时间、术中出血量、膀胱冲洗时间、留置导尿时间、血红蛋白降低指数、术后住院时间均少于对照组,而前列腺切除重量多于对照组(P<0.05)。术后,观察组IPSS评分、剩余尿量(RUV)明显低于对照组,最大尿流率(Qmax)明显高于对照组(P<0.05)。术后,两组勃起功能障碍率、逆行射精率均有所上升,但观察组的勃起功能障碍率、逆行射精率均显著低于对照组(P<0.05)。观察组术后继发出血、泌尿系统感染、尿道狭窄发生率均显著低于对照组(P<0.05)。结论:大体积BPH患者行TPKEP术的疗效优于TURP,具有出血少、恢复快、住院时间短、安全性高等优点,可改善尿道功能,降低性功能受损程度,值得在临床上推广应用。

Objective：To explore the impact of TPKEP in the treatment of benign prostatic hyperplasia（BPH）with over 80 ml volume on efficacy,urethral function and sexual function.Method：One hundred and twenty-four patients with BPH with over 80 ml volume treated in our hospital from October 2014 to October 2015 were randomly divided into the control group and the observation group,62 cases respectively.TURP was applied in the control group,while TPKEP was applied in the observation group.The operation indicators were compared.After six months of follow-up visit,urethral function,sexual function and complications were compared between before and after operation.Result：Operation time,blood loss during operation,bladder irrigation time,time for placing a urinary catheter,drop in hemoglobin and hospital stay of the observation group were shorter than those of the control group（P〈0.05）,while weight of resected prostate was significantly higher than that of the control group（P〈0.05）.The observation group had lower IPSS score and RUV and higher Qmax than the control group（P〈0.05）.After operation,erectile dysfunction rate and retrograde ejaculation rate were higher than those before operation,but those of the observation group were significantly lower than the control group（P〈0.05）.The observation group had lower incidence of secondary bleeding,urinary tract infection and urethral stricture than the control group（P〈0.05）.Conclusion：TPKEP is more effective in the treatment of BPH with over 80 ml volume than TURP,which may produce less bleeding,faster recovery,shorter hospital stay and higher safety.TPKEP helps to improve urethral function,reduce damage to sexual function,and is worthy of clinical application.