经尿道双极等离子前列腺剜除术治疗良性前列腺增生

Application of transurethral bipolar plasma kinetics enucleation of prostate on benign prostatic hyperplasia

目的探讨良性前列腺增生患者采用经尿道双极等离子前列腺剜除术治疗对其围术期指标、国际前列腺症状评分(IPSS评分)、生活质量评分(QOL评分)及并发症的影响。方法按照随机数字表法将我院2016年6月~2018年6月收治的132例良性前列腺增生患者分为对照组和观察组,每组66例。对照组采用经尿道前列腺电切术治疗,观察组采用经尿道双极等离子前列腺剜除术治疗。比较两组围术期指标(术中出血量、手术时间、尿管留置时间、住院时间),术前、术后1周的IPSS、QOL评分,血清生化指标[血清前列腺特异抗原(PSA)、雌二醇(E2)、睾酮(T)、雌雄激素比值E2/T]差异,并记录术后3个月内并发症发生情况。结果观察组术中出血量、手术时间、尿管留置时间和住院时间均明显低于对照组(均P<0.05);术后1周与术前比较,两组IPSS、QOL评分,血清PSA、E2及E2/T水平均明显下降,而T水平明显上升,且观察组变化更明显(均P<0.05);观察组患者勃起功能障碍、电切综合症及术后3个月内总的并发症发生率均明显低于对照组(均P<0.05)。结论经尿道双极等离子前列腺剜除术治疗良性前列腺增生患者能明显改善临床症状和相应指标,可提高患者生活质量,且手术方便安全,是一种有效的临床治疗手段。

ObjectiveTo explore the effects of transurethral bipolar plasma kinetics enucleation of prostate on perioperative indexes, international prostate symptom score (IPSS), quality of life (QOL) score and complications in patients with benign prostatic hyperplasia. Methods132 patients with benign prostatic hyperplasia admitted to our hospital from June 2016 to June 2018 were divided into control group and observation group according to the random number table method, with 66 cases in each group. Control group was treated with transurethral resection of prostate, and observation group was treated with transurethral bipolar plasma kinetics enucleation of prostate. Perioperative indexes (intraoperative blood loss, operative time, urinary catheter indwelling time, hospital stay), IPSS, score and QOL score before operation and at 1 w after operation and the serum biochemical indexes [serum prostate specific antigen (PSA), estradiol (E 2), testosterone (T), estrogen and androgen ratio E 2/T]were compared between the two groups. And the occurrence of complications was recorded within 3 months after operation. ResultsThe intraoperative blood loss, operative time, urinary catheter indwelling time and hospital stay in observation group were significantly lower than those in control group (all P <0.05). Compared with before operation, the scores of IPSS and QOL and levels of serum PSA, E 2 and E 2/T in the two groups at 1 w after operation were significantly decreased while the T level was significantly increased, and the changes in observation group were more obvious than those in control group (all P <0.05). The incidence rates of erectile dysfunction and electric resection syndrome and total incidence rate of complications within 3 months after operation in observation group were significantly lower than those in control group (all P <0.05). ConclusionTransurethral bipolar plasma kinetics enucleation of prostate for patients with benign prostatic hyperplasia can significantly improve the clinical symptoms and corresponding indicators, improve patients’ quality of life, and the operation is convenient and safe, and it is an effective clinical treatment method.