两种经尿道手术治疗小体积前列腺增生疗效比较

Efficacy comparision of two transurethral surgical methods in treatment of small volume BPH

目的:比较经尿道前列腺电切术(TURP)与经尿道前列腺剜除电切术(TUERP)联合经尿道膀胱颈切开术(TUIBN)治疗小体积前列腺增生(BPH)的临床疗效及安全性。方法:回顾性分析我院2009-07~2016-07行手术治疗的89例小体积BPH患者的临床资料,将其分为TURP组(n=53)和TUERP+TUIBN组(n=36)。比较两组的手术时间、切除腺体重量、术中血红蛋白丢失量及术后国际前列腺症状评分(IPSS)、生活质量评分(QOLS)和残余尿量(PVR)等指标,并记录术后并发症发生情况。结果:89例患者手术均成功,无严重出血、膀胱穿孔和前列腺电切综合征等并发症发生。TURP组手术时间为15~38min,平均(22.8±5.4)min;TUERP+TUIBN组为19~46min,平均(31.3±7.2)min,差异有统计学意义(P<0.01)。TURP组前列腺腺体切除重量为7~22g,平均(12.8±4.2)g;TUERP+TUIBN组为9~31g,平均(19.0±6.2)g,差异有统计学意义(P<0.01)。TURP组术后膀胱颈挛缩发生率为7.5%(4/53),TUERP+TUIBN组术后膀胱颈挛缩发生率为0,差异有统计学意义(P<0.05)。TUERP+TUIBN组术后IPSS评分、QOLS评分和PVR均优于TURP组,差异有统计学意义(P<0.05)。结论:经尿道前列腺剜除电切术联合经尿道膀胱颈切开术治疗小体积前列腺增生安全有效,是治疗小体积前列腺增生的一种较理想的术式。

Objective：To compare the efficacy and safety of transurethral resection of prostate（TURP）,transurethral enucleation and resection of prostate（TUERP）combined with transurethral incision of bladder neck（TUIBN）in treatment of small volume benigh prostatic hyperplasia（BPH）.Methods：Eighty-nine patients with small volume BPH who underwent operations from July 2009 to July 2016 in our hospital were divided into TURP group（n=53）and TUERP＋TUIBN group（n=36）.The operation time,the weight of prostate removed,IPSS,QOLS and PVR after operation were compared in two groups,and postoperative complications were recorded.Results：Eighty-nine cases were operated successfully and without complications such as severe bleeding,bladder perforation and transurethal resection of syndrome（TURS）.The operation time was 15-38 min,a mean of（22.8±5.4）min in TURP group,and 19-46 min,a mean of（31.3±7.2）min in TUERP＋TUIBN group（P〈0.01）.The weight of prostate removed was 7-22 g,a mean of（12.8±4.2）g in TURP group,and 9-31 g,a mean of（19.0±6.2）g in TUERP＋TUIBN group（P 〈0.01）.The incidences rate of bladder neck contracture in TURP group was 7.5%（4/53）,and 0（0/36）in TUERP＋TUIBN group（P〈0.05）.IPSS,QOLS and PVR of TUERP＋TUIBN was better than those of TURP group after operation（P〈0.05）.Conclusion：TUERP＋TUIBN is safe and effective in treatment of small volume BPH.It is an optimal treatment for the patients with small volume BPH.