经尿道等离子前列腺剜除术治疗良性前列腺增生Transurethral Bipolar Plasma Kinetics Enucleation in the Treatment of Benign Prostate Hyperplasia
屈维龙;汪益民;尤志新;
QU Weilong;WANG Yimin;YOU Zhixin;Urinary Surgery,The Second People's Hospital of Kunshan City;
摘要(Abstract):
目的:观察经尿道双极等离子前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的临床疗效。方法:106例BPH患者均分为观察组(行PKEP)和对照组(行经尿道双极等离子前列腺电切术,PKRP),记录两组患者手术时间、膀胱冲洗时间及术中出血量用于评价手术效果;记录两组患者手术前和术后6月时患者的残余尿量(RUV)和最大尿流率(Qmax)用于评价术后患者尿道功能恢复情况;比较两组患者继发性出血、暂时性尿失禁、膀胱痉挛、尿道损伤等手术并发症。结果:观察组的手术时间、术间出血量及膀胱冲洗时间均明显低于对照组(P<0.05);治疗后,两组患者RUV少于治疗前,Qmax高于治疗前(t=24.45、21.8、58.2、36.43,P<0.01);治疗后两组患者RUV和Qmax比较,观察组RUV少于对照组,Qmax高于对照组(t=22.39、20.56,P<0.01);治疗后两组均未发生永久性尿失禁病例,观察组并发症发生率(7.55%)低于对照组(22.64%),差异有统计学意义(χ2=4.71,P<0.05)。结论:PKEP治疗良性前列腺增生的效果优于PKRP。
Objective:To observe the effectiveness and safety of transurethral bipolar plasma kinetic enucleation of the prostate(PKEP) in treatment of benign prostate hyperplasia(BPH).Methods:106 cases of patients with BPH were divided into observation group(PKEP) and control group(transurethral plasma kinetic resection of prostate,PKRP).The operation time,intraoperative blood loss and bladder irrigation time in two groups of patients were recorded to evaluate the effect of surgery.Preoperative and postoperative residual urine volume(RUV) and maximum urinary flow rate(Qmax)were recorded in the two groups of patients to evaluate patients' postoperative urethral function recovery.The secondary bleeding,temporary urinary incontinence,bladder spasm,urethral injury and other surgical complications were compared between the two groups of patients.Results:The operation time,intraoperative blood loss and the time of bladder irrigation in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the RUV in two groups of patients was less than before treatment,while Qmax was higher than before treatment(t=24.45,21.8,58.2,36.43,P<0.01).After treatment,the two groups of patients with RUV and Qmax comparison,the observation group RUV less than the control group,Qmax higher than the control group(t=22.39,20.56,P<0.01);After treatment,the RUV in the observation group was less than that of the control group while Qmax was higher than that of the control group(t=22.39,20.56,P<0.01).After treatment,there was no permanent urinary incontinence cases occurring in the two groups.The complication rate of the observation group(7.55%) was lower than that of the control group(22.64%),and the difference was statistically significant(χ~2=4.71,P<0.05).Conclusion:The effect of PKEP in the treatment of benign prostatic hyperplasia is better than that of PKRP.
关键词(KeyWords):
良性前列腺增生症;经尿道双极等离子前列腺剜除术;经尿道双极等离子电切术;残余尿量;最大尿流率;并发症
benign prostate hyperplasia;transurethral plasma kinetic enucleation of the prostate;transurethral plasma kinetic resection of the prostate;residual urine volume;maximum urinary flow rate;complication
基金项目(Foundation): 苏州科学技术局医疗卫生应用基础研究指导性立项(SYSD2016039)
作者(Author):
屈维龙;汪益民;尤志新;
QU Weilong;WANG Yimin;YOU Zhixin;Urinary Surgery,The Second People's Hospital of Kunshan City;
Email:
DOI: 10.19367/j.cnki.1000-2707.2016.12.017
参考文献(References):
- [1]何京伟,谭健秋,冯能卓,等.经尿道双极等离子前列腺剜除术治疗良性前列腺增生症[J].中国医药指南,2014(1):94-95.
- [2]丁焱,周义生,沈建庆.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比较[J].中国初级卫生保健,2009(1):104-105.
- [3]Rowhrborm CG,Mc Connell JD.“Etiology,pathophysiology,epidemiology and natural history of benign prostatic hyperplasia.”In:Campbell’s Urology[M].Edited by PC Walsh,AB Retik,ED Vaughan,Jr.Philadelphia,PA:W.B.Saunders Company,2002 chapt 38:1297-1330.
- [4]Zhao Z,Zeng G,Zhong W,et al.A prospective,randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia:three-year follow-up results[J].European Urology,2010(5):752-758.
- [5]那彦群,叶章群,孙光.中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2011:219.
- [6]罗文清,王明,苟欣,等.经尿道前列腺剜除术与电切术治疗高危良性前列腺增生的安全性和疗效比较[J].重庆医科大学学报,2011(12):1524-1527.
- [7]杜刚.经尿道前列腺等离子双极电切术治疗前列腺增生120例的临床体会[J].中国社区医师:医学专业,2012(5):41.
- [8]李胜,曾宪涛,郭毅,等.经尿道等离子腔内剜除术与经尿道等离子双极电切术比较治疗良性前列腺增生的Meta分析[J].武汉中国循证医学杂志,2011(10):1172-1183.
- [9]王亮,曹文锋,杨航,等.经尿道前列腺等离子双极电切术治疗超高龄良性前列腺增生临床观察[J].四川医学,2012(9):1567-1569.
- [10]包志强.经尿道前列腺等离子腔内剜除术在治疗前列腺增生症中的应用[J].吉林医学,2011(32):6836-6837.
- [11]曹嘉正,庞健,吴荣海.经尿道双极等离子体前列腺刻除术的并发症分析[J].岭南现代临床外科,2013(2):120-123.
- [12]吴荣海,程州平,庞建,等.经尿道双极等离子体前列腺剜除术治疗高危重度前列腺增生症[J].中国煤炭工业医学杂志,2014(8):1321-1323.
- [13]陈明,刘修恒,张继来.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(12):859-862.
- [14]张建勋,许忠,李强,等.经尿道等离子腔内剜除术与切除术治疗前列腺增生[J].河南大学学报:医学版,2010(4):283-285.
- [15]卞军.经尿道前列腺双极等离子腔内剜除除术与切除术治疗良性前列腺增生的疗效比较[D].南方医科大学,2008.
- [16]Galanakis IP,Celia A,Del Biondo D,et al.Evolving transurethral resection of the prostate:enucleation-resection of the prostate[J].J Endourol,2010(12):2043-2046.
- [17]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(12):1405-1408.
- [18]陈江平.TURP和TPKEP对良性前列腺增生症近远期疗效的影响[J].贵阳医学院学报,2016(4):491-494.
- [19]苏雁峰.经尿道等离子前列腺剜除术治疗老年良性前列腺增生的疗效[J].贵阳医学院学报,2015(6):647-652.
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