PKEP治疗巨大良性前列腺增生的基层医院经验
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摘要
目的探讨经尿道等离子剜除术治疗巨大良性前列腺增生的临床经验。方法将2016年3月至2017年3月我科收治的45例巨大前列腺增生患者分为两组,分别应用经尿道前列腺等离子剜除术(PKEP组)23例和经尿道等离子前列腺电切术(PKRP组)22例进行治疗,对比两组的相关临床指标。结果两组手术时间相比,差异无统计学意义(t=1.132,P>0.05)。PKEP组切除前列腺组织较PKRP组更多(t=3.462,P<0.01),且术中出血量减少(t=5.395,P<0.01),且PKEP组未出现穿孔发生。随访3个月两组IPSS及QOL明显下降,残余尿明显减少。PKEP组IPSS及QOL显著低于PKRP组,差异具有统计学意义(t=2.093,P<0.05;t=2.761,P<0.01)。两组PVR差异则无统计学意义,住院时间也无显著差异(P>0.05)。结论与PKRP相比,PKEP可切除更多前列腺增生组织,术中出血少,手术更安全。
Objective To investigate the curative effect of transurethral plasmakinetic enucleation for treatment of large benign prostatic hyperplasia. Methods Forty-five cases of huge benign prostatic hyperplasia patients from March 2016 to March 2017 were assigned to two groups,PKRP group(treated with plasmakinetie resection of the prostate,n=22)and PKEP group(treated with plasma kinetic enucleation of the prostate,n=23). The related clinical indicators were recorded and compared between two groups. Results There was no significant difference between the two groups in operation time(t=1.132,P>0.05). The PKEP group had more prostate tissue resection than PKRP group(t=3.462,P<0.01),and the intraoperative blood loss was reduced(t=5.395,P<0.01),and no perforation occurred in the PKEP group. After 3 months of follow-up,the IPS and QOL of the two groups decreased significantly,and the residual urine decreased significantly. The IPSS and QOL of PKEP group were significantly lower than of PKRP group,and the difference was statistically significant(t=2.093,P<0.05;t=2.761,P<0.01).There was no significant difference in PVR and hospitalization time between the two groups(P>0.05).Conclusion Compared with PKRP,PKEP can excise more effective benign prostatic hyperplasia,has less intraoperative bleeding,and is a safer surgical approach.
Objective To investigate the curative effect of transurethral plasmakinetic enucleation for treatment of large benign prostatic hyperplasia. Methods Forty-five cases of huge benign prostatic hyperplasia patients from March 2016 to March 2017 were assigned to two groups,PKRP group(treated with plasmakinetie resection of the prostate,n=22)and PKEP group(treated with plasma kinetic enucleation of the prostate,n=23). The related clinical indicators were recorded and compared between two groups. Results There was no significant difference between the two groups in operation time(t=1.132,P>0.05). The PKEP group had more prostate tissue resection than PKRP group(t=3.462,P<0.01),and the intraoperative blood loss was reduced(t=5.395,P<0.01),and no perforation occurred in the PKEP group. After 3 months of follow-up,the IPS and QOL of the two groups decreased significantly,and the residual urine decreased significantly. The IPSS and QOL of PKEP group were significantly lower than of PKRP group,and the difference was statistically significant(t=2.093,P<0.05;t=2.761,P<0.01).There was no significant difference in PVR and hospitalization time between the two groups(P>0.05).Conclusion Compared with PKRP,PKEP can excise more effective benign prostatic hyperplasia,has less intraoperative bleeding,and is a safer surgical approach.
引文
[1] Jiwrajka M,Yaxley W,Perera M,et al. Review and update of benign prostatic hyperplasia in general practice[J]. Aust J Gen Pract,2018,47(7):471-475.
[2] Liu C,Zheng S,Li H,Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J]. J Urol,2010,184(6):2440-2445.
[3]曹嘉正,庞健,吴荣海,等.经尿道等离子前列腺剜除术与电切术治疗高危良性前列腺增生的比较[J].岭南现代临床外科,2013,13(3):195-198.
[4] Pinheiro LC,Martins Pisco J. Treatment of benign prostatic hyperplasia[J]. Tech Vasc Interv Radiol,2012,15(4):256-260.
[5] Pasha MT,Khan MA,Jamal Y,et al. Postoperative complications with glycine and sterile distilled water after transurethral resection of prostate[J]. J Ayub Med Coll Abbottabad,2015,27(1):135-139.
[6] Moharari RS,Khajavi MR,Khademhosseini P,et al. Sterile water as an irrigating fluid for transurethral resection of the prostate:anesthetical view of the records of 1600 cases[J]. South Med J,2008,101(4):373-375.
[7] Mordasini L,Moschini M,Mattei A,Iselin C. GreenLight Laser for benign prostatic hyperplasia[J]. Curr Opin Urol,2018,28(3):322-328.
[8] Luo YH,Shen JH,Guan RY,et al. Plasmakineticenucleation of the prostate vsplasmakinetic resection of the prostate for benign prostatic hyperplasia:comparison of outcomes according to prostate size in 310 patients[J]. Urology,2014,84(4):904-910.
[9] Liu C,Zheng S,Li H,Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J]. J Urol,2010,184(6):2440-2445.
[2] Liu C,Zheng S,Li H,Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J]. J Urol,2010,184(6):2440-2445.
[3]曹嘉正,庞健,吴荣海,等.经尿道等离子前列腺剜除术与电切术治疗高危良性前列腺增生的比较[J].岭南现代临床外科,2013,13(3):195-198.
[4] Pinheiro LC,Martins Pisco J. Treatment of benign prostatic hyperplasia[J]. Tech Vasc Interv Radiol,2012,15(4):256-260.
[5] Pasha MT,Khan MA,Jamal Y,et al. Postoperative complications with glycine and sterile distilled water after transurethral resection of prostate[J]. J Ayub Med Coll Abbottabad,2015,27(1):135-139.
[6] Moharari RS,Khajavi MR,Khademhosseini P,et al. Sterile water as an irrigating fluid for transurethral resection of the prostate:anesthetical view of the records of 1600 cases[J]. South Med J,2008,101(4):373-375.
[7] Mordasini L,Moschini M,Mattei A,Iselin C. GreenLight Laser for benign prostatic hyperplasia[J]. Curr Opin Urol,2018,28(3):322-328.
[8] Luo YH,Shen JH,Guan RY,et al. Plasmakineticenucleation of the prostate vsplasmakinetic resection of the prostate for benign prostatic hyperplasia:comparison of outcomes according to prostate size in 310 patients[J]. Urology,2014,84(4):904-910.
[9] Liu C,Zheng S,Li H,Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J]. J Urol,2010,184(6):2440-2445.