经尿道等离子双极前列腺剜除术联合电切术治疗良性前列腺增生的临床对照研究

Controlled Clinical Trial of Transurethral Plasmakinetic Enucleation and Electrocision for Benign Prostatic Hyperplasia

目的比较经尿道等离子双极前列腺剜除术(plasmakinetic enucleation of the prostate,PKEP)联合单纯等离子电切术(plasmakinetic resection of the prostate,PKRP)与单纯PKRP治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床效果及安全性。方法前瞻性纳入作者医院诊断为BPH并伴有下尿路症状的患者共234例,根据治疗方式不同分为联合组(PKEP+PKRP治疗)87例和对照组(单纯PKRP治疗)147例,对两组术前、术中及术后随访3个月的资料进行比较分析。结果两组术前基本资料差异无统计学意义(P>0.05)。与对照组相比,联合组手术时间较长、切除腺体更多,减少了术中出血量、术后膀胱冲洗时间、术后尿管留置天数和住院时间,组间比较差异具有统计学意义(P<0.05)。术后3个月随访,两组前列腺症状评分、生活质量评分、最大尿流率、残余尿量等指标较术前均有显著改善,但两组间比较差异无统计学意义(P>0.05)。结论 PKEP联合PKRP治疗BPH安全、有效,且对患者的损伤较小,患者恢复快。

Objective To compare the safeties and efficiencies of transurethral plasmakinetie enucleation of the prostate （PKEP） combined with plasmakinetic resection of the prostate （PKRP） and single PKRP in treatment of benign prostatic hyperplasia （BPH）. Methods Two hundred and thirty-four BPH patients diagnosed with lower urinary tract symptom in author＇ hospital were prospectively enrolled and divided into combined group （PKEP ＋ PKRP treatment, n = 87） and control group （single PKRP treatment, n = 147） based on different treatment methods. The perioperative, intra- operative and postoperative follow-up data between two groups were compared and analyzed. Results No differences were found in the preoperative general data between two groups （P〉0. 05）. Compared with the control group, the combined group had longer operative time, more gland tissues excision, but less intraoperative blood loss, postoperative bladder ir rigation time, catheterization time and hospital stay （P〈0. 05）. After 3 month follow-up, the prostate symptom score, quality of life, maximum urinary flow rate and residual urine volume all improved in both two groups, but there was no significantly difference between two groups （P〉0. 05）. Conclusion Combination of PKEP and PKRP is safe and effective for BPH, with less damage and faster recovery to the patients.