经尿道柱状水囊前列腺扩开术与电切术治疗老年前列腺增生的效果对比

Comparison of effects of transurethral split of the prostate and transurethral resection of the prostate in the treatment of elderly benign prostatic hyperplasia

目的观察对比经尿道柱状水囊前列腺扩开术(TUSP)与电切术(TURP)治疗老年前列腺增生的效果及预后。方法选取2016年1月至2018年1月于安阳市第三人民医院接受手术治疗的90例老年前列腺增生病人,按手术方式不同分为扩开组(接受TUSP治疗)与电切组(接受TURP治疗)各45例,比较两组病人治疗后围手术期指标,尿动力学,国际前列腺症状评分与生活质量评分以及预后与并发症发生的变化情况。结果术后3个月,扩开组与电切组的PVR[(15.91±2.83)mL、(16.07±2.89)mL]明显低于术前[(68.43±11.27)mL、(68.51±11.32)mL](P<0.05),Qmax[(22.48±4.13)mL/s、(22.53±4.17)mL/s]明显高于术前[(7.96±1.41)mL/s、(8.05±1.46)mL/s](P<0.05),IPSS评分、QOL评分[扩开组(8.12±1.27)分、(2.08±0.36)分,电切组(2.08±0.36)分、(2.15±0.40)分]明显低于术前[(25.49±8.61)分、(25.57±8.64)分,(4.26±0.73)分、(4.31±0.76)分](P<0.05),均差异无统计学意义(P>0.05)。术后12个月,扩开组和电切组PSA[(0.98±0.15)μg/L、(1.04±0.18)μg/L]明显低于术前[(5.13±0.86)μg/L、(5.02±0.79)μg/L](P<0.05),扩开组和电切组比较,差异无统计学意义(P>0.05);扩开组并发症发生率低于电切组(P<0.05)。结论TUSP与TURP均可有效治疗老年前列腺增生,但TUSP在改善病人围手术期指标以及并发症方面比TURP更具有优势。

ObjectiveTo observe and compare the effects and prognosis of transurethral split of the prostate(TUSP)and transurethral resection of the prostate(TURP)in the treatment of elderly benign prostatic hyperplasia.MethodsA total of 90 elderly patientswith benign prostatic hyperplasia who underwent surgery in the Third People’s Hospital of Anyang City from January 2016 to January2018 were selected and assigned into split group(treated with TUSP)and electric resection group(treated with TURP),with 45 cases ineach group.The perioperative indicators,urodynamics,international prostate symptom score and quality of life score,prognosis and occurrence of complications were compared between the two groups of patients.ResultsCompared with electric resection group,the operative time,postoperative urinary catheter indwelling time and hospital stay were shorter in split group,and the intraoperative blood losswas less.At 3 months after operation,the PVRin split group[(15.91±2.83)mL vs.(68.43±11.27)mL]and electric resection group[(16.07±2.89)mL vs.(68.51±11.32)mL]were obviously lower than before surgery(P<0.05),while the Qmaxin split group[(22.48±4.13)mL/s vs.(7.96±1.41)mL/s]and electric resection group[(22.53±4.170)mL/s vs.(8.05±1.46)mL/s]were significantly higher than those before surgery(P<0.05),and there were no significant differences between split group and electric resection group(P>0.05).The scores of IPSS and QOL in split group[IPSS:(8.12±1.27)points vs.(25.49±8.61)points],[QOL:(2.08±0.36)points vs.(25.57±8.64)points]and electric resection group[IPSS:(2.08±0.36)points vs.(4.26±0.73)points],[QOL:(2.15±0.40)points vs.(4.31±0.76)points]were significantly lower thanthose before surgery(P<0.05),and there were no statistically significant differences between split group and electric resection group(P>0.05).At 12 months after operation,the PSA in split group[(0.98±0.15)μg/L vs.(5.13±0.86)μg/L]and electric resection group[(1.04±0.18)μg/L vs.(5.02±0.79)μg/L]were significantly lower than before surgery(P<0.05),and there were no significant differences at 12 months after operation between split group and electric resection group(P>0.05).The incidence rate of complications in split group waslower than that in electric resection group(P<0.05).ConclusionBoth TUSP and TURP can effectively treat elderly benign prostatic hyperplasia,but TUSP is more advantageous than TURP in terms of improving perioperative indicators and complications in patients.