经尿道柱状水囊前列腺扩开术两种手术方式治疗良性前列腺增生效果分析

Analysis of the effect of two surgical methods in the treatment of benign prostatic hyperplasia

目的探究经尿道等离子腔内前列腺剜除术(plasmakinetic enucleation and resection of the prostate,PKERP)与经尿道等离子切除术(plasmakinetic resection of prostate,PKRP)对体积<100mL良性前列腺增生(benign prostatic hyperplasia,BPH)患者膀胱功能、性功能和并发症所产生的影响。方法选取2017年3月至2018年9月钟祥市人民医院泌尿外科诊治的100例良性前列腺增生患者为研究对象。按照不同手术方法将其分为观察组和对照组,每组50例患者。观察组患者采取经尿道等离子腔内前列腺剜除术(PKERP),对照组患者采取经尿道等离子切除术(PKRP)。比较两组患者治疗后的膀胱功能、性功能和并发症发生情况。结果两组患者经过治疗后,同组比较,国际前列腺症状评分(international prostate symptom scores,IPSS)和生活质量评分(quality of life,QOL)评分均有显著降低,其差异均具有统计学意义(均P<0.05)。组间比较发现,观察组患者的IPSS评分为(6.84±1.13)分,QOL评分为(1.17±0.26)分,均显著低于对照组患者,其差异均具有统计学意义(t=5.351,4.082,均P<0.05)。两组患者治疗前后最大尿流率(the maximum flow rate,Qmax)、最大尿道关闭压(maximum urethral closure pressure,MUCP)和国际勃起评分表(intemational index of erectile function 5,IIEF-5)比较,同组差异均具有统计学意义(均P<0.05);同时,观察组患者治疗后Qmax[(16.74±3.16)mL/s]、MUCP[(36.04±5.22)cm H2O]、IIEF-5[(24.76±3.57)分]均显著高于对照组患者,其差异均具有统计学意义(t=5.827,8.193,4.696,均P<0.05)。观察组患者并发症总发生率(4.0%)显著低于对照组患者(30.0%),其差异具有统计学意义(χ2=6.171,P<0.05)。结论 PKERP对于良性前列腺增生治疗后患者的膀胱功能的保留,性功能的保留效果更好,并发症显著降低,具有较高安全性,值得临床推广应用。

Objective To investigate the effects of plasmakinetic enucleation and resection of the prostate(PKERP) and plasmakinetic resection of prostate(PKRP) on the bladder function, sexual function and complications in patients with volume <100 mL benign prostatic hyperplasia(BPH). Methods 100 patients with BPH treated between March 2017 and September 2018 were selected and divided into the control group and the observation group, 50 patients in each group. The control group underwent PKRP and the observation group received PKERP. The bladder function, sexual function and incidence of complications in the two groups were compared after treatment. Results After treatment, the international prostate symptom scores(IPSS) score and quality of life(QOL) score of the two groups were significantly decreased, with statistically significant differences(all P<0.05). The IPSS scores and QOL scores of the observation group were(6.84±1.13) points and(1.17±0.26) points respectively, which were significantly lower than those in the control group, with statistically significant differences(t=5.351, 4.082, all P<0.05). There were statistically significant differences in the maximum flow rate(Qmax), maximum urethral closure pressure(MUCP) and international index of erectile function 5(IIEF-5) between before and after treatment in the two groups(all P<0.05). The Qmax [(16.74±3.16) mL/s], MUCP [(36.04±5.22) cm H2O] and IIEF-5 [(24.76±3.57) points] in the observation group after treatment were significantly higher than those in the control group, with statistically significant differences(t=5.827, 8.193, 4.696, all P<0.05). The total incidence of complications in the observation group(4.0%) was significantly lower than that of the control group(30.0%), with statistically significant difference(χ2=6.171, P<0.05). Conclusions PKERP retains the bladder function and sexual function of patients with BPH after treatment, with decreased incidence of complications and high safety, which is worthy of clinical promotion.