经直肠高能聚焦超声与经尿道手术治疗前列腺增生症的对比研究

目的研究经尿道前列腺切除术(TURP)、经尿道等离子体双极前列腺电切术(PKRP)和经直肠高强度聚焦超声系统(HIFU)治疗前列腺增生症的临床疗效。方法将120例良性前列腺增生症(BPH)手术患者随机分为3组,每组40例,分别行TURP、PKRP和HIFU前列腺消融术治疗,回顾分析并比较各组术后一般情况及并发症等。复查的有关指标,对所测指标进行统计学分析。结果3组病人术前一般情况比较差异无显著性(P>0.05)。HIFU组在术后相关指标及并发症发生率与TURP组和PKRP组差异有显著性(P<0.05),HIFU组的手术时间、住院时间明显短于TURP组和PKRP组,并发症明显低于TURP组和PKRP组。TURP组和PKRP组在手术时间、住院时间、尿道狭窄发生率和逆行射精发生率两者差异无显著性(P>0.05)。各组术后主、客观症状均较术前明显改善,比较差异有显著性(P<0.05)。术后1年时HIFU组、TURP和PKRP组各主、客观指标比较差异无显著性(P>0.05)。结论TURP、PKRP和HIFU前列腺消融术均是治疗BPH的有效方法,而HIFU前列腺消融术是一种治疗BPH最安全、痛苦最小、恢复最快、并发症最少的的方法。

A comparative study and evaluations on the results of TURP,PKRP and transrectal high intensity focused ultrasound for the treatment of benign prostatic hyperplasia

Objective] To study and compare the effective of TURP, PKRP and high intensity focused ultrasound for the treatment of benign prostatic hyperplasia. Methods] 120 cases of BPH were treated with TURP (n =40), PKRP (n =40), HIFU (n =40), and the therapeutic effects were evaluated. Results] There was no significant difference of pretherapy factors between the three groups (P >0.05). IPSS, QOLS, PV, Qmas, RUV are significantly improved in each group after the procedure (P <0.05). The aueraye amount of bleeding, TURS occurring, the mean bladder irrigating time, resident time in HIFU group was less or shorter than that in TURP and PKRP group. 12 months postoperatively, there was no obvious IPSS, QOLS, PV, Qmas, RUV in each group after the procedure (P <0.05). Conclusion] The means of transrectal high intensity focused ultrasound for treatment of BPH is safer than TURP and PKRP group.