经尿道等离子前列腺电切术和剜除术治疗良性前列腺增生的效果及对排尿功能的影响

Efficacy of TUPKRP and TUPKEP on benign prostatic hyperplasia and their influences on urination function

目的探讨经尿道等离子前列腺电切术(TUPKRP)和经尿道等离子前列腺剜除术(TUPKEP)治疗良性前列腺增生(BPH)的疗效及对排尿功能的影响。方法选取2017年1月至2021年12月民航总医院收治的160例BPH患者,采用随机数字表法分为TUPKEP组和TUPKRP组,各80例,分别择期行TUPKEP和TUPKRP手术。比较两组手术相关指标,比较两组术前和术后1个月最大尿流率(Qmax)、平均尿流率(AFR)、残余尿量(PVR),以及国际前列腺症状评分(IPSS)、生活质量(QOL)评分、并发症发生率。结果TUPKEP组手术时间、拔管时间和住院时间均短于TUPKRP组,术中出血量少于TUPKRP组,术后24h视觉模拟评分法(VAS)评分低于TUPKRP组(P<0.05);术后1个月,TUPKEP组Qmax、AFR高于TUPKRP组,PVR低于TUPKRP组(P<0.05);TUPKEP组IPSS显著低于TUPKRP组,QOL评分显著高于TUPKRP组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与TUPKRP比较,TUPKEP治疗BPH疗效确切,排尿功能改善明显,安全性好。

Objective To explore the effect of transurethral plasmakinetic resection of prostate(TUPKRP)and transurethral plasmakinetic enucleation of prostate(TUPKEP)on benign prostatic hyperplasia(BPH)and their influences on urination function.Methods A total of 160 patients with BPH admitted to Civil Aviation General Hospital were enrolled between January 2017 and December 2021.According to random number table method,they were divided into TUPKEP group(80 cases)and TUPKRP group(80 cases),which underwent selective TUPKEP and TUPKRP operation respectively.The sugery-related indicators were compared between two groups.Maximum flow rate(Qmax),average flow rate(AFR)and post void residual(PVR)before and at 1 month after surgery,international prostate symptom score(IPSS)and score of quality of life(QOL)were compared between the two groups.The occurrence of complications in both groups was recorded.Results The operation time,extubation time and hospitalization stay in TUPKEP group were shorter than those in TUPKRP group,intraoperative blood loss was less than that in TUPKRP group,and visual analogue scale(VAS)score at 24 h after surgery was lower than that in TUPKRP group(P<0.05).At 1 month after surgery,Qmax and AFR in TUPKEP group were higher than those in TUPKRP group,while PVR was lower than that in TUPKRP group(P<0.05).IPSS in TUPKEP group was lower than that in TUPKRP group,and QOL score was higher than that in TUPKRP group(P<0.05).The difference in incidence of complications between TUPKEP group and TUPKRP group was not statistically significant(3.75%vs.5.00%)(P>0.05).Conclusions Compared with TUPKRP,curative effect of TUPKEP is more significant on BPH,which can significantly improve urination function with good safety.