等离子与汽化电切术治疗前列腺增生的效果及术后膀胱颈挛缩的影响因素

目的探究经尿道等离子前列腺电切术（TUPKRP）与经尿道前列腺汽化电切术（TUVP）治疗前列腺增生（BPH）的效果，并分析术后膀胱颈挛缩（BNC）的影响因素。 方法前瞻性的选取2018年1月至2020年1月我院泌尿外科收治的90例BPH患者作为研究对象。数字表法随机分成对照组（45例，TUVP）和观察组（45例，TUPKRP），对比两组患者治疗前、治疗3个月后的临床资料，以是否发生BNC为分组依据，分析术后BNC的影响因素。 结果组内比较，两组患者治疗3个月后IPSS、PSA、表皮生长因子（EGF）及前列腺素E2（PGE2）均显著低于治疗前（P<0.05），Q_max显著高于治疗前（P<0.05）；组间同时点比较，治疗后观察组患者IPSS、PSA、EGF及PGE2均显著低于对照组患者（P<0.05），且Q_max显著高于对照组患者（P<0.05）。发生BNC组患者合并前列腺炎、冲洗温度<34℃、导管灌注量≥40 ml以及TUVP术式占比均显著高于未发生BNC组患者（P<0.05）；且Logistic分析结果显示，合并前列腺炎、冲洗温度<34℃、导管灌注量≥40 ml以及TUVP均为术后发生BNC的独立危险因素（P<0.05）。 结论TUVP、TUPKRP均可改善患者临床症状，但TUPKRP术改善效果更佳，合并前列腺炎、冲洗温度<34℃、导管灌注量≥40 ml以及TUVP术为BNC独立危险因素。

Effect of transurethral plasma kinetic resection of prostate and transurethral vaporization of prostate on benign prostatic hyperplasia and influencing factors of bladder neck contracture after operation

ObjectiveTo explore the effect of transurethral plasma kinetic resection of prostate (TUPKRP) and transurethral vaporization of prostate (TUVP) in the treatment of benign prostatic hyperplasia (BPH), and to analyze the influencing factors of bladder neck contracture (BNC). MethodsA prospective study was conducted on 90 BPH patients admitted to the Urology Department of our hospital from January 2018 to January 2020. The patients were randomly divided into the control group (45 patients underwent TUVP) and the observation group (45 patients underwent TUPKRP) by simple numerical random table method. The data of two groups were compared before treatment and 3 months after treatment. The influence factors of postoperative BNC were explored wheather BNC occurred. ResultsAfter 3 months of treatment, IPSS, PSA, EGF and PGE2 of the 2 groups were lower than that before treatment (P<0.05), and Q_max was higher than that before treatment (P<0.05). After treatment, IPSS, PSA, EGF and PGE2 of the observation group were lower than those of the control group (P<0.05), and Q_max was higher than that of the control group (P<0.05). In BNC group of patients with prostatitis, washing temperature <34 ℃, catheter perfusion ≥40 ml and TUVP proportion were significantly higher than without BNC group of patients (P<0.05). Logistic analysis showed that complications of prostatitis, flushing temperature <34℃, catheter perfusion ≥40 ml, and TUVP were independent risk factors for BNC after operation (P<0.05). ConclusionBoth TUVP and TUPKRP could improve the clinical symptoms of the patients, but TUPKRP had a better effect. However, the combination of prostatitis, flushing temperature <34℃, catheter perfusion ≥40 ml, and TUVP were independent risk factors of BNC.