经尿道等离子前列腺解剖性剜除术与经尿道前列腺电切术治疗良性前列腺增生的疗效比较

Comparison of the Effect of Transurethral Anatomical Enucleation of Prostate and Transurethral Resection of Prostate for Treatment of Benign Prostatic Hyperplasia

目的:探讨经尿道等离子前列腺解剖性剜除术(transurethral anatomical enucleation of prostate,TUAEP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效。方法:120例BPH患者根据治疗时所用不同治疗方案分成TUAEP组和TURP组,每组60例。对比两种手术方式的手术时间、前列腺切除质量、术中出血量、术后持续膀胱冲洗时间、留置导尿管时间、术后住院时间及并发症,术后3个月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)等指标。结果:两组手术时间、术后3个月随访主要指标(IPSS、QOL、PVR)等方面比较,差异均无统计学意义(P>0.05)。TUAEP组术中出血量、术后持续膀胱冲洗时间、留置导尿管时间、术后住院时间方面均明显低于TURP组(P<0.05)。TUAEP组前列腺切除质量、Qmax增加值均明显高于TURP组(P<0.05)。TUAEP组术后二次出血率低于TURP组(P<0.05),但假性尿失禁发生率高于TURP组(P<0.05)。结论:TUAEP能够更彻底地切除增生前列腺腺体,术中出血少,术后恢复快,住院时间短,安全性高,并发症少,值得临床推广。

Objective:To investigate the clinical effect of transurethral anatomical enucleation of prostate(TUAEP)and transurethral resection of prostate(TURP)for treatment of benign prostatic hyperplasia.Method:A total of 120 patients with BPH were divided into TUAEP group and TURP group according to different operation methods,each group had 60 cases.The operation time,resected tissue weight,blood loss,bladder irrigation time,intubation time,postoperative hospitalization time and complications,the international prostate symptom score(IPSS),quality of life score(QOL),residual urine volume(PVR)and maximum urinary flow rate(Qmax)within 3 months after operation of two groups were compared.Result:There were no significant differences in the operation time and main indexes(IPSS,QOL,PVR)of the postoperative 3 months between two groups(P>0.05).The blood loss,bladder irrigation time,intubation time,postoperative hospitalization time of TUAEP group were significant lower than those of TURP group(P<0.05).The resected tissue weight and the increase of Qmax of TUAEP group were significantly higher than those of TURP group(P<0.05).The rate of secondary hemorrhage of TUAEP group was lower than that of TURP group(P<0.05),but the incidence of false incontinence was higher than that of TURP group(P<0.05).Conclusion:TUAEP can remove hyperplastic prostatic gland more thoroughly.It has less bleeding,quicker postoperative recovery,shorter hospitalization time,higher safety and less complications,it is worthy of clinical promotion.