改良式经尿道前列腺等离子电切术与经尿道前列腺电切术治疗BPH的有效性及安全性比较

A comparative study on the efficacy and safety of modified plasma kinetic resection of the prostate and transurethral resection of the prostate in the treatment of benign prostatic hyperplasia

目的探讨比较改良式经尿道前列腺等离子电切术(PKRP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的有效性及安全性。方法回顾性分析2018年8月至2020年8月在北京大学第一医院接受治疗的104例BPH患者的临床资料,根据不同术式分为TURP组与改良式PKRP组,每组各52例。TURP组行TURP治疗,改良式PKRP组行改良式PKRP治疗。比较两组患者的手术时间、切除组织重量、术中出血量及拔管时间;采用国际勃起功能指数评分(IIEF-5)对两组患者的勃起自信度、插入能力、勃起维持能力评分进行比较;比较两组的国际前列腺症状评分(IPSS)、生活质量(QOL)评分;观察两组的勃起功能障碍、精液量减少、逆行射精及并发症发生情况。结果改良式PKRP组的手术时间、术中出血量、拔管时间均低于TURP组,切除组织重量高于TURP组,差异均有统计学意义(均P<0.05);改良式PKRP组的勃起自信度、插入能力、勃起维持能力均高于TURP组,差异均有统计学意义(均P<0.05);改良式PKRP组的IPSS、QOL评分均低于TURP组,差异均有统计学意义(均P<0.05);改良式PKRP组发生勃起功能障碍、精液量减少、逆行射精的情况均低于TURP组,差异均有统计学意义(P=0.006、0.046、0.025);改良式PKRP组的并发症总发生率低于TURP组,差异有统计学意义(P<0.05)。结论与TURP比较,改良式PKRP的治疗效果更好,安全性更高,患者IPSS、QOL评分更低,以及对患者出现损伤症状的影响更小,且并发症更少,值得临床推广。

Objective To explore the efficacy and safety of modified plasma kinetic resection of the prostate(PKRP)and transurethral resection of the prostate(TURP)in the treatment of benign prostate hyperplasia(BPH).Methods Retrospective analysis of clinical data of a total of 104 BPH patients who were treated in Peking university first hospital from August 2018 to August 2020 were performed and divided into TURP group and modified PKRP group,with 52 cases in each group.BPH patients in TURP group were treated by TURP,and BPH patients in modified PKRP group were treated by modified PKRP.The operation time,weight of excised tissue,bleeding volume and extubation time of the two groups were compared;the erectile confidence,insertion ability and erectile maintenance ability of the two groups were compared with the international erectile function index score(IIEF-5);the international score of prostate symptoms(IPSS)and quality of life(QOL)scores of the two groups were compared;the erectile dysfunction,semen volume reduction,retrograde ejaculation and complications of the two groups were observed.Results Compared with TURP group,the operation time,intraoperative hemorrhage and extubation time of modified PKRP group were lower,the weight of excised tissue was higher than that of TURP group(all P<0.05);the erectile confidence,insertion ability and erectile maintenance ability of modified PKRP group were higher than that of TURP group(all P<0.05);the IPSS and QOL scores of modified PKRP group were lower than that of TURP group(all P<0.05);the erectile function of modified PKRP group was better than that of TURP group(P=0.006,0.046,0.025);the total incidence of complications in the modified PKRP group was lower than that in the TURP group(P<0.05).Conclusions Compared with TURP,modified PKRP has good therapeutic effect,high safety,lower IPSS and QOL scores,less impact on patients'injury symptoms,and fewer complications,which is worthy of clinical promotion.