犁型电极(大禹刀)与环状电极等离子前列腺剜除术治疗BPH的临床比较研究

Clinical comparative study between transurethral plasma enucleation with plough-shaped electrode(Da Yu Dao)and plasmakinetic enucleation of the prostate in the treatment of benign prostatic hyperplasia

为了比较犁型电极(大禹刀)经尿道等离子剜除术与环状电极等离子前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的短期临床疗效和安全性。本研究回顾性分析2020年4—7月我院收治的62例行等离子剜除手术的BPH患者的临床资料。其中大禹刀组30例,PKEP组32例。分析两组手术时间、膀胱冲洗液量、平均住院时间、术后24 h血红蛋白下降量、术后3个月最大尿流率(Q_(max))改善情况、国际前列腺症状评分(IPSS)、残余尿(PVR)、生活质量(QOL)评分及术后早期并发症等临床数据。结果显示,大禹刀组比PKEP组的手术时间和平均住院时间更短(P<0.05),术后血红蛋白下降量及膀胱冲洗量显著低于PKEP组(P<0.05)。在疗效方面,两组患者Q_(max)、IPSS、QOL评分和PVR比较差异均无统计学意义,术后短期并发症也无明显差异。提示大禹刀等离子剜除术和PKEP术后短期疗效相似,但大禹刀具有更好的安全性和止血效果,且操控性佳,并可减少患者住院时间,值得在基层医院推广应用。

In order to compare the short-term clinical efficacy and safety between transurethral plasma enucleation with plough-shaped electrode(Da Yu Dao)and PKEP with ring-shaped electrode in the treatment of benign prostatic hyperplasia(BPH),we retrospectively analyzed the clinical data of 62 patients with BPH who underwent plasma prostate enucleation and were admitted to Lishui People’s Hospital from April 2020 to July 2020.Among them,30 cases were in Da Yu Dao group and 32 cases were in PKEP group.The operation time,bladder irrigation volume,average length of hospital stay,postoperative 24 h hemoglobin reduction,postoperative 3-month maximum urinary flow rate(Q_(max))improvement,international prostate symptom score(IPSS),postvoid residual urine volume(PVR),quality of life(QOL)score and early postoperative complications were analyzed.Studies have shown that Da Yu Dao group had shorter operation time and average hospital stay than PKEP group(P<0.05),and the postoperative hemoglobin reduction and bladder irrigation volume were significantly lower than those in the PKEP group(P<0.05).In terms of efficacy,there was no statistical difference in Q_(max),IPSS,QOL or PVR between the two groups,and there was no significant difference in short-term postoperative complications.It is suggested that plough-shaped electrode plasma enucleation and PKEP have similar clinical efficacy,but Da Yu Dao has better safety and hemostasis effect,better operability and shorter hospital stay.It is worthy of clinical application.