经尿道前列腺双极等离子电切术与前列腺电切术治疗良性前列腺增生的对比研究

Comparison of transurethral bipolar plasma resection of the prostate and electro-prostatectomy on benign prostatic hyperplasia

目的比较经尿道前列腺双极等离子电切术与前列腺电切术治疗良性前列腺增生的临床效果。方法抽取2019年11月至2022年8月平煤神马医疗集团总医院收治的良性前列腺增生患者80例,按随机数字表法分为对照组和研究组,每组40例。对照组采用前列腺电切术,研究组采用经尿道前列腺双极等离子电切术。比较两组围术期情况、尿动力学指标、前列腺素E2(PGE2)水平、前列腺特异抗原(PSA)水平、国际前列腺症状评分(IPSS)、国际勃起功能指数-5(IIEF-5)评分及并发症发生率。结果研究组手术时间、术中出血量、住院时间及尿管留置时间均少于对照组(t=5.76、13.35、16.78、19.82,P均<0.05)。术后3个月,研究组最大尿流率高于对照组(t=19.93,P<0.05),残余尿量少于对照组(t=18.76,P<0.05)。术后3个月,研究组PGE2、PSA均低于对照组(t=17.87、31.43,P均<0.05),IPSS低于对照组(t=29.39,P<0.05),IIEF-5评分高于对照组(t=10.24,P<0.05)。研究组并发症发生率(2.50%,1/40)与对照组(7.50%,3/40)比较差异未见统计学意义(P>0.05)。结论与前列腺电切术比较,经尿道前列腺双极等离子电切术治疗良性前列腺增生可改善患者围术期情况、尿动力学水平及临床症状,有一定的手术安全性。

Objective To compare the clinical effects of transurethral bipolar plasma resection of the prostate and electro-prostatectomy on benign prostatic hyperplasia.Methods A total of 80 patients with benign prostatic hyperplasia who were admitted to Pingmei Shenma Medical Group General Hospital from November 2019 to August 2022 were selected,and the patients were divided into control group and study group according to the random number table method,with 40 cases in each group.The control group received electro-prostatectomy,and the study group received transurethral bipolar plasma resection of the prostate.The perioperative conditions,urodynamic indicators,prostaglandin E2(PGE2)level,prostate-specific antigen(PSA)level,the international prostate symptoms score(IPSS),the international index of erectile function-5(IIEF-5)score and the incidence of complications were compared between the two groups.Results The operation time,intraoperative blood loss,hospitalization time and urinary catheter indwelling time in the study group were shorter than those in the control group(t=5.76,13.35,16.78,19.82;all P<0.05).Three months after operation,the maximum urinary flow rate of the study group was higher than that of the control group(t=19.93,P<0.05),and the residual urine volume of the study group was less than that of the control group(t=18.76,P<0.05).Three months after operation,the PGE2 and PSA of the study group were lower than those of the control group(t=17.87,31.43;all P<0.05),and the IPSS of the study group was lower than that of the control group(t=29.39,P<0.05),the IIEF-5 score of the study group was higher than that of the control group(t=10.24,P<0.05).There was no significant difference in the incidence of complications between the study group(2.50%,1/40)and the control group(7.50%,3/40),P>0.05.Conclusions Compared with electro-prostatectomy,transurethral bipolar plasma resection of the prostate can improve the perioperative condition,level of urodynamics and clinical symptoms of patients with benign prostatic hyperplasia,and has certain surgical safety.