经皮膀胱穿刺造瘘在经尿道前列腺等离子电切术治疗大体积前列腺增生中的前瞻性对照研究

目的探讨经皮膀胱穿刺造瘘在经尿道前列腺等离子电切术（plasma kinetic resection of prostate,PKRP）治疗大体积前列腺增生中的价值。方法2009年1月～2011年12月,将72例进行PKRP的大体积前列腺增生患者随机分为膀胱造瘘组和对照组,分别采用经皮膀胱造瘘＋PKRP或单纯PKRP。记录术前前列腺体积、手术时间、切除的前列腺质量,检测术前、术后即刻和术后1天的血清钠、钾和氯。结果与对照组相比,膀胱造瘘组切除的前列腺组织质量大[（88．66±23．48）gVS．（78．39±16．04）g,t=2．168,P=0．034],手术时间短[（74．03±30．54）minVS．（92．36±34．36）min,t=-2．393,P=0．019]。2组术后血清钠、钾和氯均正常。结论经皮膀胱穿刺造瘘可以缩短PKRP的手术时间,对血清钠、钾和氯无明显影响。

Transcutaneous Cystostomy in Transurethral Bipolar Plasma Kinetic Resection for Large-volume Benign Prostatic Hyperplasia:Prospective Controlled Study

Objective To evaluate transcutaneous cystostomy in transurethral bipolar plasma kinetic resection for massive prostatic hyperplasia. Methods From January 2009 to December 2011, 72 patients with large-volume benign prostatic hyperplasia, who were undergoing plasma kinetic resection of the prostate （PKRP） , were randomly divided into cystostomy control groups with 36 patients in each. In eystostomy group, patients received transeutaneous cystostomy plus PKRP, while the control group received PKRP only. Preoperative prostate size, operation time, volume of resected prostatic tissues were compared between the two groups. Levels of serum natrium, kalium and chlorine were measured before and at the end of surgery, as well as one day after the operation. Results Compared to the control, cystostomy group showed significantly more removed prostatic tissues and shorter operation time （88.66 ± 23.48） gvs. （78.39±16.04） g, t=2. 168, P=0.034; （74.03 ±30.54） rain vs. （92.36 ±34.36） min, t= -2.393, P= 0.019]. The levels of serum natrium, kalium and chlorine were normal after the operation in both the groups. Conclusion Cystostomy can reduce operation time for PKRP without influencing serum levels of natrium, kalium and chlorine.