两种不同电切手术方案对前列腺增生病人临床疗效及性功能的影响对比研究
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摘要
目的对前列腺增生(BPH)患者采用不同电切术治疗的效果进行评析。方法以2015年10月至2017年10月在延安市人民医院泌尿外科诊治的150例BPH患者作为观察对象,依照手术方式分成观察组和对照组,各75例;对照组采取经尿道前列腺电切术(TUVP)治疗,观察组采取经尿道双极等离子电切术(PKRP),对比两组手术情况,并测定手术前后Qmax、PRV及IPSS,随访随访3个月、6个月的阴茎勃起功能障碍(ED)、逆行射精(RE)发生情况。结果观察组术中出血量、导管留置时间及住院时间均显著短于对照组,差异具有统计学意义(P<0.05),手术时间差异无统计学意义(P>0.05);观察组术后并发症发生率为2.67%,低于对比组的13.33%,差异有统计意义(P<0.05);两组患者手术前后Qmax、PVR、IPSS评分差异有统计意义,但组间比较无明显差异,差异无统计学意义(P>0.05);术后随访3个月、6个月观察组ED发生率低于对比组,差异具有统计意义(P<0.05)。结论采用PKRP术治疗BPH,创伤小,术中出血少,术后恢复快,且对患者性功能影响小,安全性高,临床优势更为显著。
Objective To evaluate the effect of different electrosurgical treatment for(BPH) patients with benign prostatic hyperplasia(BPH).Methods From October 2015 to October 2017, 150 patients with BPH were divided into observation group(75 cases) and control group(75 cases), who were treated in the Urology Department of Yan′an People′s Hospital from October 2015 to October 2017. The control group was treated with transurethral resection of prostate(TUVP), the observation group was treated with transurethral bipolar resection of prostate(PKRP),) and the other two groups were compared. Qmax,PRV and IPSS, were followed up for 3 months before and after operation. The occurrence of(ED), retrograde ejaculation(RE) in 6 months of penile erectile dysfunction.Results The intraoperative bleeding volume, catheter indwelling time and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05), but there was no significant difference in the operation time(P>0.05). The incidence of postoperative complications in the observation group(2.67%) was lower than that in the control group(13.33%)(P<0.05). There was a significant difference in Qmax,PVR,IPSS scores between the two groups before and after operation, but there was no significant difference between the two groups(P>0 05). After 3 months of follow-up, the incidence of ED in the observation group was lower than that in the control group at 6 months, the difference was statistically significant(P<0. 05).Conclusions PKRP was used to treat BPH, with less trauma, less bleeding during operation, faster recovery after operation, less influence on sexual function, higher safety, and more significant clinical advantages.
Objective To evaluate the effect of different electrosurgical treatment for(BPH) patients with benign prostatic hyperplasia(BPH).Methods From October 2015 to October 2017, 150 patients with BPH were divided into observation group(75 cases) and control group(75 cases), who were treated in the Urology Department of Yan′an People′s Hospital from October 2015 to October 2017. The control group was treated with transurethral resection of prostate(TUVP), the observation group was treated with transurethral bipolar resection of prostate(PKRP),) and the other two groups were compared. Qmax,PRV and IPSS, were followed up for 3 months before and after operation. The occurrence of(ED), retrograde ejaculation(RE) in 6 months of penile erectile dysfunction.Results The intraoperative bleeding volume, catheter indwelling time and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05), but there was no significant difference in the operation time(P>0.05). The incidence of postoperative complications in the observation group(2.67%) was lower than that in the control group(13.33%)(P<0.05). There was a significant difference in Qmax,PVR,IPSS scores between the two groups before and after operation, but there was no significant difference between the two groups(P>0 05). After 3 months of follow-up, the incidence of ED in the observation group was lower than that in the control group at 6 months, the difference was statistically significant(P<0. 05).Conclusions PKRP was used to treat BPH, with less trauma, less bleeding during operation, faster recovery after operation, less influence on sexual function, higher safety, and more significant clinical advantages.
引文
[1] 柯磊磊,刘斌,疏仁义,等.经尿道等离子双极电切术治疗前列腺增生的临床分析[J].中国医药科学,2014,4(10):14-16.
[2] 唐天成.经尿道等离子电切术治疗老年前列腺增生的临床体会[J].中外医学研究,2016,14(14):17-18.
[3] 肖伟,杨科,吴万瑞,等.经尿道前列腺电切术与经尿道双极等离子电切术治疗良性前列腺增生的疗效比较[J].中国性科学,2012,21(10):20-23.
[4] 叶章群.泌尿外科疾病诊疗指南[M].北京:科学出版社,2005:135.
[5] 朱江.经尿道前列腺电切术治疗良性前列腺增生症的临床体会[J].中国医药指南,2014,12(25):285-286.
[6] 张菊根,吴振启,郭建明.经尿道双极等离子电切术对良性前列腺增生的疗效及其对性功能影响的研究[J].热带医学杂志,2012,12(10):1211-1213.
[7] 吴在德,吴肇汉.外科学[M].北京:人民卫生出版社,2010:673-676.
[8] 刘俊峰,谭朝晖,李三祥,等.经尿道双极等离子前列腺剜除术与经尿道双极等离子电切术比较治疗前列腺增生的临床研究[J].中国循证医学杂志,2013,13(12):1405-1408.
[9] 张菊根,吴振启,郭建明.经尿道双极等离子电切术治疗良性前列腺增生症的临床研究[J].现代中西医结合杂志,2013,22(6):631-632.
[10] 胡建云,万能文,邓宏,等.经尿道双极等离子电切术治疗良性前列腺增生的临床效果[J].中国当代医药,2015,22(34):82-84.
[11] 林升汉,黄卫,孙占玉,等.经尿道等离子前列腺剜除术和电切术治疗前列腺增生的疗效差异分析[J].中国性科学,2017,26(3):15-18.
[12] 刘龙,旷建刚.经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床效果[J].中国医药导报,2016,13(27):95-98.
[13] 梅烁.经尿道前列腺电切术治疗前列腺增生的疗效观察[J].当代医学,2011,17(3):67-68.
[14] Kwon JS,Lee JW,Lee SW,et al.Comparison of effectiveness of monopolar and bipolar transurethral resection of the prostate and open prostatectomy in large benign prostatic hyperplasia[J].Korean J Urol,2011,52(4):269-273.
[15] 杨学刚.经尿道等离子双极电切术治疗良性前列腺增生的疗效评价[J].中国民族民间医药,2011,1(2):24-27.
[16] 黄明坦,叶泽兵,刘百川,等.经尿道前列腺等离子双极电切治疗高危良性前列腺增生症的临床疗效观察[J].海南医学,2014,11(4):498-500.
[17] Choi HS,Kim DJ,Kim DS,et al.Factors affecting theimprovement of the initial peak urinary flow rate after transurethral resection of the prostate or photoselective vaporization of the prostate for treating benign prostatic hyperplasia[J].Int Neurourol J,2011,15(1):35-40.
[18] 利宏泰,张东文,王磊.经尿道前列腺电切术治疗良性前列腺增生症的临床体会[J].中国卫生产业,2011,10(26):93-95.
[2] 唐天成.经尿道等离子电切术治疗老年前列腺增生的临床体会[J].中外医学研究,2016,14(14):17-18.
[3] 肖伟,杨科,吴万瑞,等.经尿道前列腺电切术与经尿道双极等离子电切术治疗良性前列腺增生的疗效比较[J].中国性科学,2012,21(10):20-23.
[4] 叶章群.泌尿外科疾病诊疗指南[M].北京:科学出版社,2005:135.
[5] 朱江.经尿道前列腺电切术治疗良性前列腺增生症的临床体会[J].中国医药指南,2014,12(25):285-286.
[6] 张菊根,吴振启,郭建明.经尿道双极等离子电切术对良性前列腺增生的疗效及其对性功能影响的研究[J].热带医学杂志,2012,12(10):1211-1213.
[7] 吴在德,吴肇汉.外科学[M].北京:人民卫生出版社,2010:673-676.
[8] 刘俊峰,谭朝晖,李三祥,等.经尿道双极等离子前列腺剜除术与经尿道双极等离子电切术比较治疗前列腺增生的临床研究[J].中国循证医学杂志,2013,13(12):1405-1408.
[9] 张菊根,吴振启,郭建明.经尿道双极等离子电切术治疗良性前列腺增生症的临床研究[J].现代中西医结合杂志,2013,22(6):631-632.
[10] 胡建云,万能文,邓宏,等.经尿道双极等离子电切术治疗良性前列腺增生的临床效果[J].中国当代医药,2015,22(34):82-84.
[11] 林升汉,黄卫,孙占玉,等.经尿道等离子前列腺剜除术和电切术治疗前列腺增生的疗效差异分析[J].中国性科学,2017,26(3):15-18.
[12] 刘龙,旷建刚.经尿道前列腺汽化电切术联合钬激光碎石术同期治疗良性前列腺增生症合并膀胱结石的临床效果[J].中国医药导报,2016,13(27):95-98.
[13] 梅烁.经尿道前列腺电切术治疗前列腺增生的疗效观察[J].当代医学,2011,17(3):67-68.
[14] Kwon JS,Lee JW,Lee SW,et al.Comparison of effectiveness of monopolar and bipolar transurethral resection of the prostate and open prostatectomy in large benign prostatic hyperplasia[J].Korean J Urol,2011,52(4):269-273.
[15] 杨学刚.经尿道等离子双极电切术治疗良性前列腺增生的疗效评价[J].中国民族民间医药,2011,1(2):24-27.
[16] 黄明坦,叶泽兵,刘百川,等.经尿道前列腺等离子双极电切治疗高危良性前列腺增生症的临床疗效观察[J].海南医学,2014,11(4):498-500.
[17] Choi HS,Kim DJ,Kim DS,et al.Factors affecting theimprovement of the initial peak urinary flow rate after transurethral resection of the prostate or photoselective vaporization of the prostate for treating benign prostatic hyperplasia[J].Int Neurourol J,2011,15(1):35-40.
[18] 利宏泰,张东文,王磊.经尿道前列腺电切术治疗良性前列腺增生症的临床体会[J].中国卫生产业,2011,10(26):93-95.