经尿道前列腺剜除术与电切术的疗效及安全性比较

目的比较经尿道前列腺剜除术(TUEP)与经尿道前列腺电切术(TURP)治疗前列腺增生症(BPH)的疗效及安全性。方法以TURP治疗BPH 193例,以TUEP治疗BPH 137例,通过比较其术中出血量、手术时间、手术完毕时低血钠发生率和术后并发症发生情况,评价两种方法治疗BPH的安全性;通过比较其前列腺增生腺体切除重量、术后导尿管留置时间、术后3个月最大尿流率(Qmax)、残余尿量(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、电切环消耗率,比较两种方法治疗BPH的疗效。结果 TUEP治疗组术中出血量、手术完毕时低血钠发生率、手术时间、术后导尿管留置时间、电切环消耗根数(率)均低(短、少)于TURP治疗组(P<0.05或0.01),前列腺切除重量高于TURP治疗组(P<0.01);术后3个月两组Qmax、RUV、IPSS、QOL较术前均明显改善(P<0.01),但两组间比较差异无显著性(P>0.05)。结论 TUEP术与TURP术相比较,TUEP术出血少,手术完毕时低血钠发生率低,手术时间短,电切环消耗根数(率)少,切除增生腺体更彻底,疗效确切,值得进一步推广应用。

A comparative study of the clinical safety and efficacy between transurethral enucleation of the prostate and transurethral resection of the prostate for benign prostatic hyperplasia

Objective To compare the efficacy and safety of Transurethral enucleation of the prostate(TUEP) and Transurethral resection of prostate(TURP) in the treatment of patients with benign prostatic hyperplasia(BPH).Methods 193 patients were treated by Transurethral enucleation of the prostate(TURP) and 137 patients by Transurethral resection of prostate(TUEP).Parameters included intraoperative blood loss,operating time,intraoperative hyponatremia,postoperative complications were compared to evaluated the clinical safety of TEUP and TURP for the treatment of BPH;Resected tissue weighed,catheterization time,the consumption of TURP ring and maximum urinary flow rates(Qmax),residual urine volume(RUV),International Prostate Symptom Score(IPSS),quality of life score(QOL) were compared to evaluated the clinical efficacy.Results In TUEP group,the intraoperative blood loss,operating time,the incidence of intraoperative hyponatremia and the consumption of TURP ring were significantly lower than those of TURP group(P<0.01),but the resected tissue weighed were significantly higher than that of TURP group(P<0.05 or 0.01).Qmax,RUV,IPSS and QOL were significantly improved 3 months postoperatively in both group(P<0.01),but there were no significant differences in the above parameters between two groups(P>0.05).Conclusion Because of its less blood loss,less operating time,less incidence of intraoperative hyponatremia,less consumption of TURP ring,more resected tissue weighed,rapid recovery and assured clinical effect,TUEP deserves our application.