经尿道等离子前列腺剜除治疗良性前列腺增生疗效分析

Treatment effect of plasmakinetic enucleation of prostate on benign prostatic hyperplasia

关键词:  良性前列腺增生  经尿道前列腺电切  经尿道等离子前列腺剜除

Key words:  [Key words] benign prostatic hyperplasia  transurethral resection of prostate  transurethral plasmakinetic enucleation of the prostate

摘要:

[摘要] 　目的　探讨经尿道等离子双极电刀前列腺剜除（PKEP）治疗良性前列腺增生（BPH）的临床应用。 方法　选择大连医科大学附属第二医院2012年11月—2013年5月，具有手术指征，单纯的BPH患者共计140例，年龄61~84岁，平均68.6岁，随机分为2组。PKEP组（60例）行经尿道等离子双极电刀前列腺剜除术（PKEP），TURP组（80例）行经尿道前列腺电切术（TURP）。统计每例患者术前国际前列腺症状评分（IPSS）、生活质量评分（QOL）和最大尿流率（Qmax），手术时间、术中术后有无并发症、输血，术后尿管留置时间、平均住院日及术后2周IPSS、QOL、Qmax。 结果　两组IPSS、QOL、Qmax术前术后比较差异有显著性意义（P<0.05），但两组间比较无明显差异（P>0.05）。两组平均手术时间差异无显著性意义（P>0.05），PKEP组和TURP组患者平均尿管留置时间分别为(46.2±12.5)h和(92.6±20.8)h；平均住院日分别为（7.2±2.4）d和（9.1±2.1）d。两组比较差异有显著性意义（P<0.05）。所有患者术中术后均无输血，TURP组患者术中3例出现电切综合征（TURS）。结论　等离子腔内前列腺剜除手术安全、有效，且具有术后尿管留置时间少及住院时间短等优点，可作为治疗BPH的一种选择。

Abstract:

[Abstract] Objective To evaluate clinical application of transurethral plasmakinetic enucleation of the prostate (PKEP) in the treatment of benign prostatic hyperplasia (BPH). Methods A total of 140 BPH patients in our hospital, aged 61-84 (mean 68.6) years, with indication of surgery, underwent transurethral plasmakinetic enucleation of the prostate (PKEP group, n=60) or transurethral resection of prostate (TURP group, n=80). Pre- and post-operative International Prostate Symptom Score (IPSS), quality of life (QOL) and maximum urinary flow rates (Qmax), as well as intra- and post-operative bleeding and complications were recorded and analyzed. Results There were significant differences between pre-and post-operative IPSS，QOL and Qmax in both PKEP and TURP groups（P<0.05). However, the values were not significantly different when compared between the two groups（P>0.05）. The operation times were not significantly different between the two groups. The mean time of hospitalization was （7.2±2.4）d in PKEP group, versus （9.1±2.1）d in TURP group, and the duration of catheterization was (46.2±12.5) h and (92.6±20.8) h, respectively（P<0.05）. One hundred patients did not receive blood transfusion both intra- and post-operation. Three patients in TURP group were complicated by mild intra-operative transurethral resection syndrome (TURS). Conclusion PKEP is a safe and effective procedure, which has less time of mean hospitalization and catheterization. PKEP can be chosen as surgical treatment for BPH.