经尿道棒状水囊前列腺扩开与经尿道前列腺等离子汽化电切术治疗高危良性前列腺增生患者的中长期临床疗效

Mid and long-term clinical efficacy of transurethral columnar balloon catheter split of the prostate and transurethral plasma vaporization resection of the prostate in the treatment of high-risk patients with benign prostatic hyperplasia

目的比较经尿道棒状水囊前列腺扩开术与经尿道前列腺等离子汽化电切术治疗高危良性前列腺增生患者的中长期临床疗效,探讨其临床应用价值,并总结手术经验。方法选取2012年1月至2018年8月安徽医科大学第一附属医院收治的174例高危良性前列腺增生患者作为研究对象。根据不同的手术方法分为A组(采用经尿道棒状水囊前列腺扩开术,n=83)和B组(采用经尿道前列腺等离子汽化电切术,n=91)。比较两组的手术时间、血红蛋白丢失量、术后持续膀胱冲洗时间、留置尿管时间;对两组进行3年的随访,记录术后第1年、第2年、第3年的国际前列腺症状评分法(IPSS)评分、最大尿流率(Qmax)及残余尿量(RUV)。结果两组均一次性手术成功,无更改其他术式。A组的手术时间、术后持续膀胱冲洗时间、留置尿管时间均短于B组,血红蛋白丢失量小于B组,差异具有统计学意义(P<0.05)。两组术后第1年、第2年、第3年的IPSS评分、Qmax及RUV均较术前明显改善,差异具有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论经尿道棒状水囊前列腺扩开术与经尿道前列腺等离子汽化电切术均可有效治疗高危良性前列腺增生患者,但经尿道棒状水囊前列腺扩开术的手术时间更短,出血量更少,术后恢复更快,且其中长期临床疗效与经尿道前列腺等离子汽化电切术相似。

Objective To compare the mid and long-term clinical efficacy of transurethral columnar balloon catheter split of the prostate and transurethral plasma vaporization resection of the prostate in the treatment of high-risk patients with benign prostatic hyperplasia,to explore its clinical application value and summarize the surgical experience.Methods A total of 174 patients with high-risk benign prostatic hyperplasia admitted to the First Affiliated Hospital of Anhui Medical University from January 2012 to August 2018 were selected as the research objects.According to different surgical methods,the patients were divided into two groups:group A(transurethral columnar balloon catheter split of the prostate,n=83) and group B(transurethral plasma vaporization resection of the prostate,n=91).The operation time,loss of hemoglobin,continuous bladder flushing time and indwelling catheter time were compared between the two groups.The international prostate symptom score(IPSS),maximum urinary flow rate(Qmax) and residual urine volume(RUV) were recorded at 1,2 and 3 years after surgery.Results The two groups of patients were successful in one operation,no change in other operation.The operation time,continuous bladder flushing time and indwelling catheter time in group A were shorter than those in group B,and the loss of hemoglobin was also less than that in group B.There were statistically significant differences in perioperative related indicators between the two groups(P0.05).Conclusions Both transurethral columnar balloon catheter split of the prostate and transurethral plasma vaporization resection of the prostate can effectively treat high-risk benign prostatic hyperplasia,but transurethral columnar balloon catheter split of the prostate open surgery of shorter operation time,less bleeding,faster recovery,the long-term clinical curative effect was same with transurethral plasma vaporization resection of the prostate.