TKRP治疗前列腺增生的临床疗效及其对血清PSA水平的影响

目的探讨经尿道前列腺等离子双极电切术治疗良性前列腺增生(BPH)的临床疗效、安全性以及对患者血清PSA水平的影响。方法 336例BPH患者根据手术方式分为经尿道前列腺等离子双极电切术(TKRP)组和经尿道前列腺电切术(TURP)组,观察两组手术时间、术中出血量、前列腺切除量及住院时间,术后随访3个月,观察两组IPSS评分、QOL评分、术后Qmax及术后并发症发生。术前和术后1个月检测两组患者血清PSA水平。结果 TKRP组手术时间、术中出血量、住院时间显著低于TURP组,腺体切除量显著高于TURP组,相比较均有统计学意义(P<0.01)。TKRP组术后IPSS评分、QOL评分、住院时间显著低于TURP组,尿流率显著高于TURP组,差异有统计学意义(P<0.01)。TKRP组术后无并发症发生。与术前比较,术后两组血清PAS水平显著降低((P<0.01),且TKRP组血清PAS水平显著低于TURP组,差异有统计学意义(P<0.01)。结论 TKRP具有手术时间短,出血量少,患者恢复快,并能明显提高患者术后生活质量,术后无并发症发生,而且可以抑制PSA的释放。TKRP是治疗BPH安全、有效的手术方法。

Clinical efficacy of TKRP surgery and its effect on serum PSA level for treating the patients with benign prostatic hyperplasia

Objective To investigate the clinical efficacy and safety of transurethral plasmakinetic resection of prostate （TKRP） in patients with benign prostatic hyperplasia （BPH）, and the impact on patients＇ serum prostate specific antigen （PSA） levels. Methods A total of 336 cases of patients with BPH were divided into TKRP group and transurethral resection of the prostate （TURP） group according to the surgical approach. The operation time, blood loss, weight of resection of prostate and hospitalization time of the two groups were observed. The patients were followed up for 3 months, the IPSS score, QOL score, postoperative Qmax and postoperative complications of the two groups were observed. Before surgery and 1 month after surgery the serum PSA levels of two groups were detected. Results The operation time, blood loss and hospitalization time of TKRP group were significantly lower than TURP group, the weight of resection of prostate was significantly higher than the TURP group, compared to both the significant difference （P 〈 0.01 ）. The postoperative IPSS and QOL scores of TKRP group were significantly lower than TURP group, the postoperative Qmax was significantly higher than the TURP group, compared to both the significant difference （P 〈 0.01 ）. There were no complications in the TKRP group. Compared with the preoperative PAS level, the postoperative PAS levels of the two groups reduced signifieantly（P 〈 0.01 ）, and the PAS level of TKRP group was lower than the TURP group, compared the difference was significant（P 〈 0.01 ）. Conclusion The TKRP has a shorter operative time, less bleeding, patients recover quickly and no postoperative complications. It can significantly improve the quality of life of patients and inhibit the release of the PSA. The TKRP is a safe and effective surgical method for treating the BPH.