经尿道前列腺等离子双极电切术治疗良性前列腺增生的疗效观察及安全性评估

目的比较经尿道前列腺等离子双极电切术与耻骨上经膀胱前列腺切除术治疗良性前列腺增生的疗效。方法选择2009年5月至2012年9月石棉县人民医院泌尿外科收治的良性前列腺增生患者120例随机分为两组,观察组(60例)给予经尿道前列腺等离子双极电切术和对照组(60例)给予耻骨上经膀胱前列腺切除术,观察手术相关指标、术后应激指标以及远期预后情况。结果观察组平均手术时间缩短50.6 min、术中出血量减少28.8 mL、术后引流量减少15.6 mL、术后卧床时间缩短2.1 d、血糖偏低1.3 mmol/L,同样,Hamilton焦虑量表评分、Hamilton抑郁量表、国际前列腺症状评分和疼痛情绪数字评分均低于(或少于)对照组(P<0.01);胰岛素水平、生活质量评分、卡氏行为状态评分表评分显著高于对照组(P<0.01)。结论经尿道前列腺等离子双极电切术能够减小手术创伤、缓解术后应激、改善远期预后,具有积极的临床价值。

Study on the Efficacy and Safety Assessment of Transurethral Plasma Kinetic Bipolar Prostate Resection in the Treatment for Benign Prostatic Hyperplasia

Objective To compare the efficacy of transurethral plasma kinetic bipolar prostate resection and suprapubic transbladder prostate resection in the treatment for benign prostate hyperplasia.Methods A total of 120 cases of prostatic hyperplasia patients admitted in Shimian People＇s Hospital from May 2009 to Sep.2012 were randomly divided into two groups,with 60 cases in each group：patients in the observation group were treated with transurethral plasma kinetic bipolar prostate resection and patients in the control group were treated with suprapubic transbladder prostate resection.Surgery=related indicators,stress indicators and long-term prognosis of the two groups were observed.Results As to the observation group,the mean operation time decreased for 50.6 min,amoung of intraoperative blood loss decreased for 28.8 mL,amount of postoperative drainage decreased for 15.6 mL,postoperative time in bed decreased for 2.1 d,blood sugar level was 1.3 mmol/L lower than the control group.Moreover,Hamilton anxiety scale,Hamilton depression scale,international prostate symptom score and numerical rating scale of pain emotion of the observation group were significantly lower than those in the control group,there were statistically significant differences（P ＜ 0.01）.And levels of insulin,score of life quality,Karnofsky performance status rating scale of the observation group were significantly higher than those in the control group,there were statistically significant differences（P ＜ 0.01）.Conclusion Transurethral plasma kinetic bipolar prostate resection can reduce surgical trauma,relieve stress after surgery,and improve long-term prognosis,that has positive importance for clinical practice.