经尿道等离子电切术治疗前列腺增生及对疼痛介质、单核细胞趋化因子-1和前列腺特异抗原的影响

Application of plasma resection in patients with prostatic hyperplasia and its effect on pain mediators,monocyte chemoattractant factor-1 and prostate specific antigen

目的研究经尿道等离子电切术(TUPKRP)治疗前列腺增生及对疼痛介质、单核细胞趋化因子(MCP)-1和前列腺特异抗原(PSA)的影响。方法2016年9月~2019年10月在我院接受治疗的前列腺增生病人100例,依据随机数字表法分为对照组和研究组,每组50例。对照组采用经尿道前列腺电切术(TURP)治疗,研究组采用TUPKRP治疗,观察并对比两组围术期情况,手术前后疼痛介质,MCP-1和PSA水平,最大尿流率(Q_(max)),国际前列腺症状评分表(IPSS),生活质量(QOL)评分变化情况及并发症。结果研究组术中出血量、手术时间、膀胱冲洗时间、导管留置时间和住院时间少于对照组,差异有统计学意义(P<0.05)。术后24小时,两组疼痛介质均上升,研究组低于对照组,差异有统计学意义(P<0.05)。术后6个月,两组MCP-1和PSA水平均下降,组间比较差异无统计学意义(P>0.05)。术后6个月,两组Q_(max)均上升,IPSS和QOL评分均下降,组间比较差异无统计学意义(P>0.05)。研究组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论TUPKRP治疗前列腺增生能够达到和TURP相似的手术效果,均可降低MCP-1和PSA水平,但TUPKTP的疼痛介质影响较小,安全性更高。

Objective To study the effect of plasma electrotomy(TUPKRP)on pain mediators,monocyte chemoattractant factor-1(MCP-1)and prostate specific antigen(PSA)in patients with benign prostatic hyperplasia.Methods 100 patients with benign prostatic hyperplasia treated in our hospital from September 2016 to October 2019 were selected as the research objects,and were divided into control group and research group according to random number table method,with 50 cases in each group.The control group was treated with rransurethral resection of prostate(TURP),while the research group was treated with TUPKRP.The perioperative conditions,pain medium,MCP-1 and PSA levels,maximum urinary flow rate(Q_(max)),International Prostate Symptom Score(IPSS),quality of life(QOL)score changes and complications were observed and compared between the two groups.Results The intraoperative blood loss,operation time,bladder irrigation time,catheter indwelling time and hospitalization time in the research group were less than those in the control group(P<0.05).24 hours after the operation,the pain medium in the two groups increased,while that in the research group was lower than that in the control group,the comparison has statistical difference(P<0.05).Six months after the operation,the levels of MCP-1 and PSA in both groups decreased,and there was no statistical difference between the two groups(P>0.05).Six months after the operation,Q_(max)increased,IPSS and QOL scores decreased in both groups.there was no statistical difference between the two groups(P>0.05).The total incidence of complications in the research group was lower than that in the control group(P<0.05).Conclusion TUPKRP can achieve similar surgical effects to TURP in the treatment of prostatic hyperplasia,and both can reduce MCP-1 and PSA levels,but Tupkp has less influence on pain medium and higher safety.