腔内分部剜切术与经尿道前列腺等离子双极电切术治疗前列腺增生症的疗效分析

摘要

目的：比较腔内分部剜切术与经尿道前列腺等离子双极电切术（TUPKP）治疗良性前列腺增生症（BPH）的安全性和疗效。方法收集 BPH 手术患者285例，分别行腔内分部剜切术（165例）与 TUPKP（120例）。分析两组患者的手术时间、术中失血量、术后冲洗时间；比较两组手术患者术前、术后（第1天）血红蛋白及红细胞压积，记录两组手术短期并发症发生率；术前及术后（3个月）测定最大尿流率（Qmax）和残余尿量（RUV），记录术前、术后国际前列腺症状评分（IPSS）及生活质量（QOL）评分并给予比较。结果分部剜切组平均手术时间[（66．5±10．0）min]与TUPKP 组[（65．4±10．1）min]差异无统计学意义；在术中失血量、术后冲洗时间方面，分部剜切组较 TUPKP 组比较有统计学意义。结论腔内分部剜切术具有可操作性强、术中出血少、术后冲洗时间短及术后尿失禁发生率低等优点，是治疗 BPH 患者安全、有效的手术方式之一。%Objective To compare the therapeutic efficacy of divided transurethral enucleation of the prostate with bipolar transurethral plasmakinetic prostatectomy(TUPKP)on prostate hyperplasia.Meth-ods A total of 285 benign prostate hyperplasia(BPH)cases were treated with divided transurethral enu-cleation(165 cases)and TUPKP(120 cases)separately.The operation time,blood loss,postoperative flush time were analyzed.Preoperative and postoperative(the first postoperative day)hemoglobin and hematokrit were compared and short-term complications were recorded.Preoperative and postoperative(the third post-operative month)maximum flow rate(Qmax)and residual urine volume(RUV),and postoperative IPSS and QOL scores were measured for comparison.Results There were no significant differences in average oper-ation time between the divided enucleation group and TUPKP group.But the divided enucleation group was superior to TUPKP group on blood loss and flush time.Conclusion Divided transurethral enucleation of the prostate is a safe,effective procedure for BPH,and has advantages of operability,less bleeding,short postoperative flush time and low incidence of postoperative incontinence.