经尿道前列腺切除术、经尿道前列腺等离子剜除术治疗BPH患者的术后康复和控尿功能比较及对睾酮、前列腺特异抗原水平的影响

目的 比较分析经尿道前列腺切除术（TURP）、经尿道前列腺等离子剜除术（PKEP）治疗良性前列腺增生（BPH）患者的术后康复、控尿功能及对睾酮（T）、前列腺特异抗原（PSA）水平的影响。方法 将无锡市第九人民医院及复旦大学附属华山医院2017年4月至2019年4月间收治的100例BPH患者随机分为观察组及对照组；对照组采用TURP治疗，观察组采用PKEP治疗；治疗前后对患者控尿功能进行调查，采用国际前列腺症状评分(IPSS)、最大尿流率（Q_max）及生活质量评分（QOL）对患者前列腺症状及生活质量进行评估，记录患者术后出血、膀胱刺激征、尿道狭窄和包膜穿孔等并发症发生率；治疗前后检测血清中T及PSA水平。结果 观察组术后尿失禁发生率、IPSS及残余尿量明显低于对照组，Q_max明显高于对照组，差异均有统计学意义（P<0.05）；治疗后观察组的生活质量、T及PSA水平明显低于对照组，差异有统计学意义（P<0.05）；观察组术后并发症总发生率显著低于对照组（P<0.05）。结论 相较于TURP，BPH患者采用PKEP治疗后有助于其术后康复及控尿能力提高，并显著降低其血清中T及PSA水平。

The relationship between TURP,PKEP and postoperative rehabilitation and urinary function in patients with BPH and the effect on testosterone and PSA level

Objective  To analyze the clinical efficacy of transurethral resection of the prostate(TURP) and transurethral plasma kinetic resection of the prostate(PKEP) in the treatment of benign prostate hyperplasia(BPH) patients, and the relationship between postoperative rehabilitation, urinary function and testosterone and prostate specific antigen(PSA) levels. Methods  From April 2017 to April 2019,100 patients with BPH admitted to our hospital and Huashan hospital affiliated fudan university were randomly divided into observation group and control group，the control group was treated with TURP, and the observation group was treated with PKEP. The patient's urinary function was performed before and after treatment. The patients were assessed for prostate symptoms and quality of life using the IPSS criteria, Q_max and QOL. Postoperative bleeding, bladder irritation, urethral stricture and capsule were recorded. The incidence of complications such as perforation, serum testosterone and PSA levels were measured before and after treatment. Results  The incidence of postoperative urinary incontinence in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the IPSS score and the amount of urine involved in the observation group were significantly lower than those in the control group, and Q_max was significantly higher than the control group (P<0.05). The quality of life in the observation group was significantly lower than that in the control group (P<0.05). The T and PSA levels in the observation group were significantly lower than those in the control group after treatment (P<0.05). The total incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusions  Compared with TURP, BPH patients treated with PKEP can help their postoperative recovery and urine control capacity, and significantly reduce their blood T and PSA levels.