经尿道前列腺电切术及开放手术治疗前列腺增生症疗效及安全性对比观察

Comparative study on the efficacy and safety of transurethral resection of the prostate and open surgery for benign prostatic hyperplasia

目的比较经尿道前列腺等离子双极汽化电切术(PKRP)与经膀胱前列腺切除术(开放式手术)治疗前列腺增生症(BPH)的临床效果,并对其治疗安全性进行评价。方法将BPH患者84例随机分为2组各42例。开放式手术组患者采用经膀胱前列腺切除术进行治疗,PKRP组患者则采用PKRP进行治疗。对2组患者的手术时间、术中出血量、术中输血量、患者术后膀胱冲洗时间、留置尿管时间、术后下床时间、术后进食时间、术后住院时间以及患者治疗后的并发症发生情况等进行记录并对比分析。结果 PKRP组患者的术中出血量及术中输血量均少于对照组,手术时间、患者术后膀胱冲洗时间、留置尿管时间、术后下床时间、术后进食时间及术后住院时间等均显著短于开放式手术组患者,差异均有统计学意义(P<0.05)。治疗后PKRP组患者治疗后的膀胱刺激症发生率显著低于开放式手术组,差异有统计学意义(P<0.05)。2组患者尿外渗、尿失禁、尿道狭窄及术后出血发生率比较差异无统计学意义(P>0.05)。结论 PKRP及开放手术治疗BPH均有较好的临床治疗效果,但采用PKRP能显著改善患者治疗过程中各相关临床指标,并有效降低相关并发症发生率,值得临床广泛推广应用。

Objective To compare the clinical efficacy of transurethral plasmakinetic vaporization of prostate（PKRP） and transvesical prostatectomy（open surgery） for the treatment of the patients with benign prostatic hyperplasia（BPH） and to evaluate the therapeutic safety.Methods 84 patients with BPH were randomly divided into two groups,each of 42 cases.Open surgery group used the bladder prostatectomy for treatment,PKRP patients were treated with PKRP.The operative time,intraoperative blood loss,intraoperative blood transfusion,postoperative bladder rinse time,indwelling catheter time,postoperative bed time,postoperative eating time,postoperative hospital stay,complications and other conditions of two groups were recorded and compared.Results The intraoperative blood loss and intraoperative blood transfusion in PKRP group were significantly lower than open surgery group;The operative time,postoperative bladder rinse time,indwelling catheter time,postoperative bed time,postoperative eating time,postoperative hospital stay in PKRP group were significantly shorter than open surgery group,the difference were statistically significant（P〈0.05）.The incidence of bladder irritation after treatment in PKRP group was significantly lower than that in open surgery group,the difference was statistically significant（P〈0.05）.There was no significant difference in urinary incontinence,urinary incontinence,urethral stricture and postoperative bleeding rate between two groups（P〉0.05）.Conclusion PKRP and open surgical in treatment of BPH both have a better clinical treatment,but the use of PKRP can significantly improve the treatment of patients with the relevant clinical indicators,and effectively reduce the incidence of related complications,worthy of clinical widely used.