单极与双极切割系统经尿道前列腺剜除术的比较

目的 探讨并比较单极与双极切割系统在经尿道前列腺解剖性剜除术(TUAEP)中的安全性和疗效。 方法 分别采用2种切割系统对良性前列腺增生(BPH)患者行TUAEP,单极98例,双极83例,比较2组的手术时间、前列腺切除质量、血红蛋白下降值、血Na⁺浓度、最大尿流率(Qmax)、残余尿(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)等围手术期安全及疗效指标。 结果 采用2种切割系统均能将增生的前列腺腺体完整剜除,未发生输血、前列腺包膜穿孔和电切综合征等严重并发症。单极组及双极组的手术时间分别为(55.1±6.1)和(58.3±5.4)min,前列腺切除质量分别为(35.2±5.8)和(36.5±7.4)g,术后4 h血Na⁺浓度分别为(139.96±3.59)和(140.52±4.31)mmol/L,血红蛋白分别为(129.46±12.58)和(128.79±0.5)g/L,2组比较差别均无统计学意义(P>0.05)。术后6月,2组的前列腺特异抗原(PSA)、前列腺体积、Qmax、IPSS、QOL差别均无统计学意义(P>0.05),但与同组术前比较,PSA、前列腺体积、残余尿、Qmax、IPSS、QOL均较术前明显改善,差别有统计学意义(P<0.01)。 结论 采用单极或双极切割系统均可安全有效实施TUAEP,疗效满意,单极切割系统并不增加风险。

Comparison of Bipolar Plasmakinetic Transurethral Anatomical Enucleation of theProstate and Monopolar Transurethral Anatomical Enucleation of the Prostate

Objective To compare the safety and clinical efficacy of monopolar transurethral anatomical enucleation of the prostate(M-TUAEP)with bipolar plasmakinetic transurethral anatomical enucleation of the prostate(B-TUAEP). Methods 181 patients with benign prostatic hyperplasia(BPH)were studied, 98 cases of whom underwent M-TUAEP, and 83 cases underwent B-TUAEP. The data of procedure time, the weight of removed prostate, serum sodium concentration, hemoglobin, maximum flowrate(Qmax), the IPSS score, and the QOL score were recorded and compared. Results All of 181 cases undergoing the procedures, transurethral resection syndrome was not found and no transfusion was needed. There was no difference between these two groups in procedure time(55.1±6.1)min vs(58.3±5.4)min(P=0.80); weight of removed prostate(35.2±5.8)g vs(36.5±7.4)g(P=0.74); level of serum sodium concentration(139.96±3.59)mmol/L vs(140.52±4.31)mmol/L(P=0.58); and hemoglobin(129.46±12.58)g/L vs(128.79±0.5)g/L(P=0.77); but there were significant differences in PSA, prostate volume, residual urine volume, Qmax, IPSS, and QOL between measurements preoperative and postoperative(P<0.01). Conclusions Both of these two methods of TUAEP areeffective; and there is no difference in efficacy and complication between them. Using the monopolar cutting system will not increase transurethral resection syndrome risk.