经尿道等离子前列腺剜除术和切除术治疗巨大前列腺增生的近期临床对照研究
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摘要
目的：对比分析经尿道等离子前列腺剜除术(TUERP)和经尿道前列腺电切除术(PKRP)治疗巨大前列腺增生(BPH)的近期临床疗效。
方法：回顾性分析2007年9月-2009年9月我院收治的巨大BPH(前列腺重量≥100g)患者82例,TUERP组40例,PKRP组42例。比较两组的手术时间、切除前列腺重量、冲洗液量、术中穿孔及闭孔神经反射发生率、术中出血量、膀胱冲洗时间、留置导尿管时间、住院时间、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、膀胱残余尿量(PVR)及并发症等指标的变化情况。
结果：TUERP、PKRP两组手术时间、前列腺切除重量、住院期间Hb下降值(出血量)、冲洗液量分别为(60±12.2)和(75±13.5)min、(82±15.0)和(65±15.5)g、(15.6±10.2)和(22.5±15.3)g/L、(15.4±2.0和(19.5±2.5)L,PKRP组穿孔发生率7.1%,闭孔神经反射发生率9.5%。TUERP组无1例发生。各项指标组间比较差异有显著性意义(P<0.05)。两组最大尿流率(Qmax)、膀胱残余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)术后与术前比较差异均有统计学意义(P<0.05),两组间术后IPSS、QOL比较差异均无统计学意义(P>0.05),而PVR、Qmax有统计学意义(P<0.05)。两组膀胱冲洗时间、留置导尿时间、住院时间及术后并发症比较差异均无统计学意义(P>0.05)。
结论：两种术式相比,近期手术疗效相似,但TUERP前列腺切除更彻底,有利于防止复发,手术时间短,术中出血少,安全性更高,值得推广使用。
Objective:A comparative analysis of plasma prostate transurethral enucleation (TUERP) and electrical excision (PKRP) treatment of largebenign prostatic hyperplasia (BPH) in the short term efficacy.
Methods:Retrospective analysis of September 2007-September 2009 in our hospital 82 patients with significant BPH (prostate weight≥100g), TUERP group of 40 patients, PKRP group of 42 cases. Two groups were compared operative time, prostate weight, fluid volume, intraoperative perforation and the incidence of obturator nerve reflex, blood loss, bladder washout time, indwelling catheter time, hospital stay, the International Prostate Symptom Score (IPSS), quality of life score (QOL), maximum urinary flow rate (Qmax), residual urine volume (PVR) and complications and other indicators of change.
Results:TUERP, PKRP mean operating time, resected prostate weight, decreased Hb values during hospitalization (bleeding), fluid volume, respectively (60±12.2) and (75±13.5) min, (82±15.0) and (65±15.5) g, (15.6±10.2) and (22.5±15.3) g/L, (15.4±2.0) and (19.5±2.5) L, PKRP group perforation rate of 7.1%, obturator nerve reflex was 9.5%. TUERP was no 1 case. The index difference between the two groups was significant (P<0.05). Two sets of maximum urinary flow rate (Qmax), residual urine volume (PVR), International Prostate Symptom Score (IPSS), quality of life score (QOL) after surgery compared with preoperative differences were statistically significant (P<0.05), between the two groups after IPSS, QOL was no significant difference (P> 0.05), and PVR, Qmax was statistically significant (P<0.05). Two bladder washing time, indwelling catheter time, hospital stay and postoperative complications between the two groups was statistically significant (P> 0.05).
Conclusion:The comparison of two procedures, similar to the recent surgery, but TUERP prostatectomy more thoroughly and prevent recurrence, shorter operative time, less bleeding, more secure and should be introduced.
方法：回顾性分析2007年9月-2009年9月我院收治的巨大BPH(前列腺重量≥100g)患者82例,TUERP组40例,PKRP组42例。比较两组的手术时间、切除前列腺重量、冲洗液量、术中穿孔及闭孔神经反射发生率、术中出血量、膀胱冲洗时间、留置导尿管时间、住院时间、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、膀胱残余尿量(PVR)及并发症等指标的变化情况。
结果：TUERP、PKRP两组手术时间、前列腺切除重量、住院期间Hb下降值(出血量)、冲洗液量分别为(60±12.2)和(75±13.5)min、(82±15.0)和(65±15.5)g、(15.6±10.2)和(22.5±15.3)g/L、(15.4±2.0和(19.5±2.5)L,PKRP组穿孔发生率7.1%,闭孔神经反射发生率9.5%。TUERP组无1例发生。各项指标组间比较差异有显著性意义(P<0.05)。两组最大尿流率(Qmax)、膀胱残余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)术后与术前比较差异均有统计学意义(P<0.05),两组间术后IPSS、QOL比较差异均无统计学意义(P>0.05),而PVR、Qmax有统计学意义(P<0.05)。两组膀胱冲洗时间、留置导尿时间、住院时间及术后并发症比较差异均无统计学意义(P>0.05)。
结论：两种术式相比,近期手术疗效相似,但TUERP前列腺切除更彻底,有利于防止复发,手术时间短,术中出血少,安全性更高,值得推广使用。
Objective:A comparative analysis of plasma prostate transurethral enucleation (TUERP) and electrical excision (PKRP) treatment of largebenign prostatic hyperplasia (BPH) in the short term efficacy.
Methods:Retrospective analysis of September 2007-September 2009 in our hospital 82 patients with significant BPH (prostate weight≥100g), TUERP group of 40 patients, PKRP group of 42 cases. Two groups were compared operative time, prostate weight, fluid volume, intraoperative perforation and the incidence of obturator nerve reflex, blood loss, bladder washout time, indwelling catheter time, hospital stay, the International Prostate Symptom Score (IPSS), quality of life score (QOL), maximum urinary flow rate (Qmax), residual urine volume (PVR) and complications and other indicators of change.
Results:TUERP, PKRP mean operating time, resected prostate weight, decreased Hb values during hospitalization (bleeding), fluid volume, respectively (60±12.2) and (75±13.5) min, (82±15.0) and (65±15.5) g, (15.6±10.2) and (22.5±15.3) g/L, (15.4±2.0) and (19.5±2.5) L, PKRP group perforation rate of 7.1%, obturator nerve reflex was 9.5%. TUERP was no 1 case. The index difference between the two groups was significant (P<0.05). Two sets of maximum urinary flow rate (Qmax), residual urine volume (PVR), International Prostate Symptom Score (IPSS), quality of life score (QOL) after surgery compared with preoperative differences were statistically significant (P<0.05), between the two groups after IPSS, QOL was no significant difference (P> 0.05), and PVR, Qmax was statistically significant (P<0.05). Two bladder washing time, indwelling catheter time, hospital stay and postoperative complications between the two groups was statistically significant (P> 0.05).
Conclusion:The comparison of two procedures, similar to the recent surgery, but TUERP prostatectomy more thoroughly and prevent recurrence, shorter operative time, less bleeding, more secure and should be introduced.
引文
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