分叶分隔法经尿道等离子双极电切术治疗大体积良性前列腺增生患者的效果

Effects of divided Lobectomy of transurethral plasma kinetic resection of prostate in treatment of patients with large volume benign prostatic hyperplasia

目的:观察分叶分隔法经尿道等离子双极电切术(PKRP)治疗大体积良性前列腺增生(BPH)患者的效果。方法:回顾性分析2019年3月至2020年12月该院收治的82例大体积BPH患者的临床资料,按照手术方法不同将其分为对照组和观察组各41例。对照组行经尿道前列腺电切术(TURP)治疗,观察组行分叶分隔法PKRP治疗,比较两组围术期指标(术中出血量、膀胱冲洗时间、住院时间)水平,术前和术后1个月最大尿流率(Qmax)、剩余尿量(PVR)、前列腺功能[国际前列腺症状评分表(IPSS)]评分、术前和术后6 h创伤应激指标[皮质醇(Cor)、醛固酮(ALD)、促肾上腺皮质激素(ACTH)]水平,以及并发症发生率。结果:观察组术中出血量少于对照组,膀胱冲洗时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后1个月,观察组Qmax高于对照组,PVR和IPSS评分均低于对照组,差异有统计学意义(P<0.05);术后6 h,两组Cor、ALD、ACTH水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为7.32%(3/41),低于对照组的26.83%(11/41),差异有统计学意义(P<0.05)。结论:分叶分隔法PKRP治疗大体积BPH患者可改善围术期指标水平,降低PVR、IPSS评分、创伤应激指标水平和并发症发生率,提高Qmax,效果优于TURP治疗。

Objective:To observe effects of divided Lobectomy of transurethral plasma kinetic resection of prostate(PKRP)in treatment of patients with large volume benign prostatic hyperplasia(BPH).Methods:The clinical data of 82 patients with large volume BPH admitted to the hospital from March 2019 to December 2020 were retrospectively analyzed.They were divided into control group and observation group according to different surgical methods,41 cases in each.The control group was treated with transurethral resection of the prostate(TURP),while the observation group was treated with divided Lobectomy of transurethral PKRP.The perioperative index levels(intraoperative blood loss,bladder irrigation time,hospitalization time),the maximum urinary flow rate(Qmax)before and 1 month after the surgery,the residual urine volume(PVR),the prostate function[international prostate symptom score(IPSS)]score,the traumatic stress index levels[cortisol(Cor),aldosterone(ALD),adrenocorticotropic hormone(ACTH)],and the incidence of complications were compared between the two groups before and 6 h after the surgery.Results:The intraoperative blood loss in the observation group was less than that in the control group,the bladder irrigation time and the hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).1 month after the surgery,the Qmax level of the observation group was higher than that of the control group,the PVR level and the IPSS score were lower than those of the control group,and the differences were statistically significant(P<0.05).6 h after the surgery,the levels of Cor,ALD and ACTH in the two groups were higher than those before the surgery,while those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 7.32%(3/41),which was lower than 26.83%(11/41)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Divided Lobectomy of PKRP in the treatment of the large volume BPH patients can improve the perioperative index levels,reduce the PVR level,IPSS score,traumatic stress index levels and the incidence of complications,and improve the Qmax level.Moreover,it is superior to TURP treatment.