经尿道等离子电切术治疗良性前列腺增生症的效果及安全性

Effect and safety of transurethral plasmakinetic resection of prostate for patients with benign prostatic hyperplasia

目的 探讨经尿道等离子电切术（PKRP）治疗良性前列腺增生症（BPH）的效果及安全性.方法 选取临猗县人民医院2015年5月至2017年4月收治的84例BPH患者的临床资料进行回顾性分析,按随机数字表法分为对照组42例与研究组42例.对照组行经尿道前列腺电切术（TURP）,研究组行PKRP术.统计两组手术情况、尿道功能[最大尿流率（Qmax）、残余尿量（RUV）、前列腺症状评分（IPSS）分值]、性功能[逆行射精率、勃起功能障碍（IIEF-5）评分及勃起功能障碍率]及并发症发生情况.结果 两组前列腺切除质量比较差异未见统计学意义（P〉0.05）,研究组手术时长、术中失血量、膀胱冲洗时间、留置尿管时间、住院时长均少于对照组（P均〈0.05）;术后6个月两组Qmax较治疗前增大,RUV及IPSS分值较治疗前减小,且研究组Qmax大于对照组,RUV及IPSS分值小于对照组（P〈0.05）;术后6个月两组逆行射精率及勃起功能障碍率较术前降低,IIEF-5分值较术前增高,且研究组逆行射精率（7.14％）及勃起功能障碍率（4.76％）均低于对照组（23.81％、21.43％）,IIEF-5分值高于对照组（P〈0.05）;研究组并发症发生率（7.14％）低于对照组（23.81％,P〈0.05）.结论 采取经尿道等离子电切术治疗良性前列腺增生症可减少手术创伤,缩短住院时间,改善患者尿道功能及性功能,且术后并发症较少,安全性高.

Objective To investigate the effects and safety of transurethral plasmakinetic resection of prostate （ PKRP） on benign prostatic hyperplasia （ BPH） .Methods The clinical data of 84 patients with BPH treated in the People＇ s Hospital of Linyi from May 2015 to April 2017 were retrospectively analyzed .Patients were divided into control group （42 cases） and study group （42 cases） according to the random number table method .Patients in control group were treated by transurethral resection of prostate （ TURP ） , and patients in study group were treated by PKRP . The operation conditions, urethral function [ maximum urinary flow rate （ Qmax）, residual urine volume （ RUV）, prostate symptom （IPSS） score], sexual function[retrograde ejaculation rate, erectile dysfunction （IIEF-5 ） score and erectile dysfunction rate ] and complications were statistically analyzed between the two groups .Results There was no significant difference in the quality of prostatectomy between the two groups （ P〉0.05）.The duration of operation, intraoperative blood loss, bladder irrigation time, indwelling catheter time , hospital stay in study group were significantly less than those in control group （ P〈0.05 ） .At 6 months after operation , the Qmax of the two groups increased , and the scores of RUV and IPSS decreased compared with those before treatment;the Qmax of study group was larger than that of control group , and the scores of RUV and IPSS were smaller than those of control group （ P〈0.05 ） . At 6 months after operation , the rates of retrograde ejaculation and erectile dysfunction in the two groups were lower than those before operation , and the IIEF-5 scores were higher than those before operation;the reverse ejaculation rate and erectile dysfunction rate in study group （ 7.14%, 4.76%） were lower than those in control group （23.81%, 21.43%） , and the IIEF-5 score was higher than that in control group （ P〈0.05 ） .The incidence of complications in study group （ 7.14%） was lower than that in control group （23.81%,P〈0.05 ） .Conclusions Transurethral plasmakinetic resection of prostate in the treatment of patients with BPH can reduce the surgical trauma , shorten hospital stay , and improve the urethral function and sexual function of the patients .Moreover , it has less complications and high safety .