PKEP和PKRP治疗良性前列腺增生的效果对比
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摘要
目的:对比等离子电切镜经尿道前列腺剜除术(PKEP)与前列腺电切术(PKRP)治疗良性前列腺增生的临床效果。方法:回顾性分析2012年8月-2016年1月于本院治疗的60例良性前列腺增生患者的临床资料,根据不同的手术方式将其分为观察组和对照组,每组30例。观察组采用PKEP治疗,对照组采用PKRP治疗。对比两组手术时间、术中出血量、前列腺切除质量、留置尿管、术后卧床和住院时间相关手术指标;观察术后急性尿潴留、尿道刺激、尿路感染早期并发症以及膀胱颈硬化、尿道狭窄、尿失禁中远期并发症发生情况以及随访期间前列腺生活质量评分和尿道功能改变。结果:观察组前列腺切除质量明显高于对照组,留置尿管、术后卧床以及住院时间均明显短于对照组,差异均有统计学意义(P<0.05)。两组术中出血量、手术时间对比,差异均无统计学意义(P>0.05)。观察组术后并发症总发生率明显高于对照组,差异有统计学意义(X~2=2.58,P<0.01)。术后随访1个月时,两组前列腺QOL评分及Qmax水平对比,差异均无统计学意义(P>0.05);观察组IPSS评分及RUV水平均明显低于对照组,差异均有统计学意义(P<0.05)。术后随访3个月时,两组Qmax水平对比,差异无统计学意义(P>0.05);观察组IPSS、前列腺QOL评分及RUV水平均明显低于对照组,差异均有统计学意义(P<0.05)。术后随访6、12个月,两组IPSS评分及RUV水平对比,差异均无统计学意义(P>0.05);观察组前列腺QOL评分明显低于对照组,Qmax水平明显高于对照组,差异均有统计学意义(P<0.05)。结论:PKEP及PKRP均是良性前列腺增生安全有效的手术方式,PKEP切除增生组织更彻底,术后并发症发生率低,尿道功能以及生活质量恢复好,值得在临床进一步推广。
Objective:To compare the clinical effect of PKEP and PKRP in the treatment of benign prostatic hyperplasia.Method:The clinical data of 60 patients with benign prostatic hyperplasia treated in our hospital from August 2012 to January 2016 were retrospectively analyzed.According to different operation methods,they were divided into observation group and control group,30 cases in each group.The observation group was given PKEP treatment,the control group was received PKRP treatment.The operation time,intraoperative blood loss,prostatectomy quality,indwelling urethral catheter,postoperative bed rest and hospitalization time between the two groups were compared.Postoperative acute urinary retention,urethral stimulation,urinary tract infection of early stage complications,bladder neck sclerosis,urethral stricture and urinary incontinence of middle and long term complications and the change of prostate QOL scores and urethral function during follow-up.Result:The quality of prostatectomy in the observation group was significantly higher than that in the control group;the indwelling urethral catheter,postoperative bed rest and hospitalization time were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in intraoperative blood loss and operation time between the two groups(P>0.05).The incidence of postoperative complications in the observation group was significantly higher than that in the control group,the difference was statistically significant(X~2=2.58,P<0.01).There were no significant differences in prostate QOL scores and Qmax level between the two groups after follow-up 1 month(P>0.05);the PISS score and residual urine volume in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant differences in Qmax level after follow-up 3 months(P>0.05);the IPSS score,prostate QOL score and residual urine volume in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in IPSS scores and residual urine volume after follow-up 6 and 12 months(P>0.05);the QOL score and Qmax level in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Both PKEP and PKRP are safe and effective operation methods of benign prostatic hyperplasia,PKEP has better effect on removed hyperplasia tissue,lower incidence of postoperative complications,good recovery of urinary function and quality of life,which is worthy of further promotion in clinical practice.
Objective:To compare the clinical effect of PKEP and PKRP in the treatment of benign prostatic hyperplasia.Method:The clinical data of 60 patients with benign prostatic hyperplasia treated in our hospital from August 2012 to January 2016 were retrospectively analyzed.According to different operation methods,they were divided into observation group and control group,30 cases in each group.The observation group was given PKEP treatment,the control group was received PKRP treatment.The operation time,intraoperative blood loss,prostatectomy quality,indwelling urethral catheter,postoperative bed rest and hospitalization time between the two groups were compared.Postoperative acute urinary retention,urethral stimulation,urinary tract infection of early stage complications,bladder neck sclerosis,urethral stricture and urinary incontinence of middle and long term complications and the change of prostate QOL scores and urethral function during follow-up.Result:The quality of prostatectomy in the observation group was significantly higher than that in the control group;the indwelling urethral catheter,postoperative bed rest and hospitalization time were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in intraoperative blood loss and operation time between the two groups(P>0.05).The incidence of postoperative complications in the observation group was significantly higher than that in the control group,the difference was statistically significant(X~2=2.58,P<0.01).There were no significant differences in prostate QOL scores and Qmax level between the two groups after follow-up 1 month(P>0.05);the PISS score and residual urine volume in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant differences in Qmax level after follow-up 3 months(P>0.05);the IPSS score,prostate QOL score and residual urine volume in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in IPSS scores and residual urine volume after follow-up 6 and 12 months(P>0.05);the QOL score and Qmax level in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Both PKEP and PKRP are safe and effective operation methods of benign prostatic hyperplasia,PKEP has better effect on removed hyperplasia tissue,lower incidence of postoperative complications,good recovery of urinary function and quality of life,which is worthy of further promotion in clinical practice.
引文
[1]史济洲,谷现恩.良性前列腺增生的诊疗[J].中国临床医生杂志,2012,40(4):6-10.
[2]王建业.重视良性前列腺增生症的诊治[J].中华老年医学杂志,2006,25(11):805.
[3]陈忠,叶章群.激光在良性前列腺增生症手术中的应用[J].临床泌尿外科杂志,2015,30(9):767-771,775.
[4]程伟,刘修恒,陈明,等.经尿道双极等离子前列腺剜除术对良性前列腺增生尿道功能与性功能的影响[J].现代泌尿外科杂志,2015,20(12):859-862.
[5]果宏峰,那彦群.《良性前列腺增生诊断治疗指南》解读及相关研究进展[J].现代实用医学,2014,26(10):1193-1195.
[6]殷虎明,李纲,张学锋,等.前列腺组织学炎症程度及血清hs-CRP水平与BPH患者总前列腺体积、国际前列腺症状评分的关系[J].山东医药,2016,56(23):85-87.
[7]吴炜嘉,郑汉雄,胡立群,等.BPH相关LUTS与各临床影响因素关系的研究[J].国际泌尿系统杂志,2016,36(3):353-356.
[8]任宝明.前列腺增生发生急性尿潴留的危险因素分析与评估[J].陕西医学杂志,2015,44(9):1173-1174.
[9]沈丹,曹萍,李睿,等.血清胱抑素C含量与老年良性前列腺增生症患者肾功能的相关性[J].心血管康复医学杂志,2015,24(1):16-20.
[10]任鹏,孙发,李洪辉,等.经尿道前列腺等离子体双极电切术与前列腺电切术治疗前列腺增生症的临床疗效比较[J].中国实验方剂学杂志,2010,16(14):187-188.
[11]褚校涵,许长宝,郝斌,等.前列腺双极等离子汽化电切术对心脏起搏器工作的影响观察[J].临床泌尿外科杂志,2012,27(2):146-147.
[12]徐亚文,刘春晓,郑少波,等.经尿道前列腺剜除切割法不同层面组织病理分析[J].广东医学,2008,29(1):107-109.
[13]徐遵礼,朱建平,张前兴.经尿道前列腺电切剜除术与开放手术治疗大体积前列腺增生疗效比较[J].实用医学杂志,2014,30(23):3820-3822.
[14]许小林,沈建国,金纪忠,等.PKRP与PKEP治疗高危良性前列腺增生患者临床对照[J].国际泌尿系统杂志,2015,35(6):832-836.
[15]邱功阔,周健,彭万岭,等.两种术式治疗前列腺增生症效果对比观察[J].人民军医,2015,58(2):158-159.
[16]王惠强,陈斌,刘荣福.等离子前列腺剜除术与电切术治疗前列腺增生症的疗效分析[C].2013中国中西医结合泌尿外科专业委员会第11次全国学术年会,2013.
[17]Li S,Kwong J S,Zeng X T,et al.Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia:evidence from a systematic review and meta-analysis[J].Scientific Reports,2015,5:12002.
[18]龚墅,罗晋杨.经尿道双极等离子前列腺电切术(PKRP)和前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的疗效及并发症分析[J].吉林医学,2017,38(7):1276-1278.(收稿日期:2018-03-27)(本文编辑:李莹莹)
[2]王建业.重视良性前列腺增生症的诊治[J].中华老年医学杂志,2006,25(11):805.
[3]陈忠,叶章群.激光在良性前列腺增生症手术中的应用[J].临床泌尿外科杂志,2015,30(9):767-771,775.
[4]程伟,刘修恒,陈明,等.经尿道双极等离子前列腺剜除术对良性前列腺增生尿道功能与性功能的影响[J].现代泌尿外科杂志,2015,20(12):859-862.
[5]果宏峰,那彦群.《良性前列腺增生诊断治疗指南》解读及相关研究进展[J].现代实用医学,2014,26(10):1193-1195.
[6]殷虎明,李纲,张学锋,等.前列腺组织学炎症程度及血清hs-CRP水平与BPH患者总前列腺体积、国际前列腺症状评分的关系[J].山东医药,2016,56(23):85-87.
[7]吴炜嘉,郑汉雄,胡立群,等.BPH相关LUTS与各临床影响因素关系的研究[J].国际泌尿系统杂志,2016,36(3):353-356.
[8]任宝明.前列腺增生发生急性尿潴留的危险因素分析与评估[J].陕西医学杂志,2015,44(9):1173-1174.
[9]沈丹,曹萍,李睿,等.血清胱抑素C含量与老年良性前列腺增生症患者肾功能的相关性[J].心血管康复医学杂志,2015,24(1):16-20.
[10]任鹏,孙发,李洪辉,等.经尿道前列腺等离子体双极电切术与前列腺电切术治疗前列腺增生症的临床疗效比较[J].中国实验方剂学杂志,2010,16(14):187-188.
[11]褚校涵,许长宝,郝斌,等.前列腺双极等离子汽化电切术对心脏起搏器工作的影响观察[J].临床泌尿外科杂志,2012,27(2):146-147.
[12]徐亚文,刘春晓,郑少波,等.经尿道前列腺剜除切割法不同层面组织病理分析[J].广东医学,2008,29(1):107-109.
[13]徐遵礼,朱建平,张前兴.经尿道前列腺电切剜除术与开放手术治疗大体积前列腺增生疗效比较[J].实用医学杂志,2014,30(23):3820-3822.
[14]许小林,沈建国,金纪忠,等.PKRP与PKEP治疗高危良性前列腺增生患者临床对照[J].国际泌尿系统杂志,2015,35(6):832-836.
[15]邱功阔,周健,彭万岭,等.两种术式治疗前列腺增生症效果对比观察[J].人民军医,2015,58(2):158-159.
[16]王惠强,陈斌,刘荣福.等离子前列腺剜除术与电切术治疗前列腺增生症的疗效分析[C].2013中国中西医结合泌尿外科专业委员会第11次全国学术年会,2013.
[17]Li S,Kwong J S,Zeng X T,et al.Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia:evidence from a systematic review and meta-analysis[J].Scientific Reports,2015,5:12002.
[18]龚墅,罗晋杨.经尿道双极等离子前列腺电切术(PKRP)和前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的疗效及并发症分析[J].吉林医学,2017,38(7):1276-1278.(收稿日期:2018-03-27)(本文编辑:李莹莹)