经尿道等离子前列腺剜除术与电切术治疗高危良性前列腺增生的比较

【摘要】 目的 探讨经尿道等离子前列腺剜除术(TUPKEP)与经尿道等离子前列腺电切术(TUPKRP)治疗高危良性前列腺增生(HrBPH)的安全性和有效性比较。方法 回顾性分析128例高危BPH 患者接受TUPKEP及TUPKRP两种手术方式,就两组患者的手术时间、出血量、前列腺腺体切除量、术后膀胱冲洗时间、尿管停留时间、术后住院天数、手术并发症等进行比较;对两组患者术前、术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)进行比较。结果 68例行TUPKEP,60例行TUPKRP,所有128例患者安全度过围手术期。两组患者术前情况比较无统计学差异;两组患者手术后的QOL、PVR、IPSS、Qmax与各自术前比较,其差异有统计学意义(P<0.01),但上述指标在两组之间比较的差异并无统计学意义(P>0.05)。TUPKEP组在手术的出血量、手术时间、术后膀胱冲洗时间以及术后的住院时间要明显小于TUPKRP组(P<0.05);同时,TUPKEP组前列腺腺体切除量也高于TUPKRP组(P<0.05)。结论 TUPKEP 与TUPKRP在治疗高危BPH中,二者的临床疗效相当,但TUPKEP在手术时间、术后膀胱冲洗时间和住院时间较TUPKRP短,而且出血量和并发症均较少少,是治疗高危良性前列腺增生症的安全有效的方法。

Comparison of clinical efficacy between TUPKEP and TUPKRP for the treatment of high-risk BPH patients

Objective To compare the clinical safety and efficacy between transurethral plasm- akinetic enucleation of prostate. （TUPKEP）.and transurethral plasmakinetic resection of the prostate （TUPKRP）for treatment of high-risk patients with benign prostatic hyperplasia. Methods The clinical data of 128 cases with high-risk BPH treated with TUPKEP and TUPKRP were analyzed retrospectively..The operation time,.bleeding,.resected tissue weight of prostate ,.bladder irrigating time, postoperative hospitalization time , complications, international prostate symptom score （IPSS）, quality of life score （QOL）, postvoid residua （PVR） and maximum flow rate （Qmax） were compared between two groups..Results Sixty-eight cases and 60 cases underwent TUPKEP procedure and TUPKRP procedure respectively..There was no significant differences observed basic factors in preoperative patients between the two groups （P0.05）. IPSS, QOL, PVR and Qmax were improved in the two groups after the operation.（P0.01）,.and there showed no significant difference between the two groups. （P 0.05）..The operation time,.bleeding,.bladder irrigating time,.and postoperative hospitalization time were significant shorter in TUPKEP than in TUPKRP. （P 0.05）..The resected tissue weight of prostate in TUPKEP was more than in TUPKRP （P0.05）. Conclusion There is no difference in clinical efficiency between two groups ,.but TUPKEP has advantages in operation time ,.bleeding, postoperative hospitalization time ,.mean bladder irrigating time and complications and is an effective and safe therapy for high-risk BPH.