等离子前列腺剜除术治疗良性前列腺增生的效果

Effect of plasma prostatectomyon benign prostatic hyperplasia

目的观察等离子前列腺剜术对体积>80 m L的良性前列腺增生(BPH)的治疗效果。方法将80例体积>80 mL的BPH患者,依据治疗术式不同分为两组,电切组40例,行经尿道前列腺电切术(TURP),剜除组40例,行经尿道等离子前列腺剜除术(TUERP),比较两组手术指标(住院时间、术中失血量、手术时间、前列腺清除量、膀胱冲洗时间)及术前、术后3个月、6个月国际前列腺症状量表(IPSS)、国际勃起功能指数-5(ⅡEF-5)、最大尿流率(Qmax)、残余尿量(PVR)、膀胱顺应性(BC)、去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)。结果剜除组住院时间、膀胱冲洗时间短于电切组,术中失血量少于电切组,前列腺切除量多于电切组(P<0.05);术后3个月、6个月剜除组IPSS评分低于电切组,ⅡEF-5评分高于电切组(P<0.05);术后3个月、6个月剜除组PVR低于电切组,Qmax、BC高于电切组(P<0.05);术后1 d、3 d剜除组血清E、NE、Cor水平低于电切组(P<0.05)。结论体积>80 mL良性BPH患者应用TUERP治疗,可减少手术失血量,缩短住院时间、膀胱冲洗时间,增加前列腺切除量,改善临床症状与性功能,抑制应激反应,调节尿动力。

Objective To observe the effect of plasma prostatectomyon benign prostatic hyperplasia(BPH)with volume>80 mL.Methods 80 BPH patients with volume>80 mL were divided into two groups according to the different treatment methods,40 cases in each group.The electroresection group underwent transurethral resection of the prostate(TURP),and the enucleation group underwent transurethral plasma enucleation of the prostate(TUERP).The surgical indicators(hospitalization time,intraoperative blood loss,operation time,prostate clearance,bladder irrigation time),the International Prostate Symptom Scale(IPSS)before operation,3 months after operation and 6 months after operation,International Erectile Function Index-5(ⅡEF-5),Maximum Urine Flow Rate(Qmax),Residual Urine Volume(PVR),Bladder Compliance(BC),Norepinephrine(NE),Epinephrine(E)and Cortex Alcohol(Cor)were compared between the two groups.Results The hospitalization time and bladder irrigation time of the enucleation group were shorter than those of the electroresection group;the intraoperative blood loss was less than that of the electroresection group.3 months and 6 months after surgery,the IPSS score of the enucleation group was lower than that of the electroresection group,the score ofⅡEF-5 was higher than that of the electroresection group;the PVR of the enucleation group was lower than that of the electroresection group,the Qmax and BC were higher than those of the electroresection group.The levels of serum E,NE and Cor in the enucleation group were lower than those in the electroresection group at 1 and 3 days after operation.All the difference were statistically significant.Conclusion The application of TUERP in benign BPH patients with volume>80 mL can reduce surgical blood loss,shorten hospitalization time,bladder irrigation time,increase the amount of prostatectomy,improve clinical symptoms and sexual function,inhibit stress response,and regulate urodynamics.