两种术式治疗前列腺增生症的疗效比较

目的:比较经尿道前列腺电切术(TURP)与经尿道等离子双极电切术(PKRP)治疗前列腺增生症的疗效。方法:将64例确诊为良性前列腺增生患者随机分为2组,每组各32例,分别采用TURP和PKRP,观察两组患者的手术时间、手术前后血红蛋白变化程度、术中血钠浓度、切除组织质量、包膜切穿发生率和术后留置导尿时间。结果:两组患者治疗后国际前列腺症状评分(IPSS)、生活质量评分(QOL)及最大尿流率均明显改善,组间差异无统计学意义;两组患者手术时间、出血量、术后血钠浓度及切除组织质量差异均有显著性意义(P<0.01);术后膀胱冲洗时间、留置导尿时间差异无统计学意义(P>0.05)。PKRP术中出血少,术后血钠无明显降低。两组均未发生前列腺电切综合征(TURS)及术后尿失禁。PKRP组包膜穿孔1例,无一例输血,有1例在术后出现继发性出血;TURP组包膜穿孔5例,输血3例。结论:两种术式治疗效果相近,但PKRP并发症少,更加安全,容易掌握,适合初学者使用。

A comparative study of two different surgical procedures for benign prostatic hyperplasia

Objective: To compare the effect of transurethral plasmakinetic resection of the prostate(PKRP) with that of conventional TURP for BPH.Methods: Sixty-four BPH patients were randomly divided into 2 groups of equal number and underwent PKRP and TURP respectively.Results: IPSS,QOL and maximum flow-rate were improved after both the procedures,with no statistic differences between the 2 groups.Compared with TURP,PKRP took longer operating time,but with more resected prostatic tissues,less intraoperative bleeding(P< 0.01)and no hyponatremia.There were no significant differences in bladder washout and postoperative catheterization between the 2 groups(P>0.05),nor TURS and urinary incontinence in either of them.Prostate surgical envelope was damaged in 1 case in the PKRP and 5 cases in the TURP group,with1 case of secondary bleeding in the former and 3 cases of blood transfusion in the latter.Conclusion: PKRP and TURP produce similar results in the treatment of BPH,but the former is safer,easier and with fewer complications.