低容量经尿道前列腺电切术治疗高危良性前列腺增生的临床观察

Outcome of high-risk BPH patients treated with low-volume TURP

目的 探讨低容量经尿道前列腺电切术 (low volumeTURP)治疗良性前列腺增生的临床效果及安全性。 方法 对 76例高危良性前列腺增生患者采用标准TURP(39例 )和低容量TURP(37例 )手术治疗。对 2组手术时间、术中出血量、术后膀胱冲洗时间、手术并发症、术后IPSS、最大尿流率(Qmax)、剩余尿量变化值等进行比较。 结果 标准TURP组和低容量TURP组平均手术时间分别为(6 7.5± 18.2 )、(16 .4± 3.5 )min(P =0 .0 11) ;术中出血量分别为 (15 8.4± 4 7.3)、(5 4 .7± 2 5 .2 )ml(P =0 .0 13) ;术后膀胱冲洗时间分别为 (4 .9± 1.8)、(1.3± 0 .5 )d(P =0 .0 2 9) ;术后住院时间分别为 (7.6± 2 .9)、(2 .4± 1.3)d(P =0 .0 37)。IPSS评分分别降低 19.3± 7.6、15 .3± 9.7(P =0 .4 6 ) ;剩余尿量分别减少(134.9± 6 8.6 )、(16 3.8± 94 .5 )ml(P =0 .17) ;最大尿流率分别增加 (13.4± 8.8)、(11.7± 9.1)ml/s(P =0 .79)。 37例低容量TURP病例中 31例随访 2～ 18个月 ,平均 10个月 ,疗效满意。 结论 低容量TURP治疗BPH有效 ,具有手术时间短、创伤小等优点 ,增加了高危患者对手术的耐受性。

Objective To evaluate the clinical efficacy and safety of low-volume TURP on patients with BPH. Methods A total of 76 high-risk patients with BPH were treated with either standard TURP (Group 1,n=39) or low-volume TURP(Group 2,n=37).The operative duration,blood loss,postoperative irrigation time,IPSS,Qmax,postvoid urine residual volume (PURV) were comparatively evaluated. Results In Groups 1 and 2,the operation durations were (67.5±18.2)min and (16.4±3.5)min (P= 0.011);blood loss,(158.4±47.3)ml and (54.7±25.2)ml (P=0.013);postoperative irrigation time (4.9±1.8)d and (1.3±0.5)d (P=0.029);IPSS change (19.3±7.6) and (15.3±9.7)(P=0.46);Qmax (13.4±8.8)ml/s and (11.7±9.1)ml/s (P=0.79);PURV (134.9±68.6)ml and (163.8± 94.5)ml (P=0.17) respectively.31 cases in Group 2 (low-volume TURP) were followed up for 2 to 18 months (mean,10 months) with satisfactory results. Conclusions The low-volume TURP is effective and characterized by shorter operative duration,minimal-invasion and better tolerance for the high-risk patients with BPH.