实用医学杂志 ›› 2020, Vol. 36 ›› Issue (24): 3394-3398.doi: 10.3969/j.issn.1006⁃5725.2020.24.018

• 临床研究 • 上一篇    下一篇

保留前叶经尿道前列腺剜除术治疗前列腺增生的5年疗效分析

林阳彦, 邱春明 ,杨勇, 孙灿标, 张国飞   

  1. 南方医科大学南海医院泌尿外科(广东佛山 528244)
  • 出版日期:2020-12-25 发布日期:2021-01-19
  • 基金资助:
    佛山市科技计划项目(编号:2017AB000672)

Analysis of 5⁃year efficacy of transurethral plasmakineticenucleation of prostate with anterior lobe preser⁃ vation in the treatment of benign prostatic hyperplasia

LIN Yangyan,QIU Chunming,YANG Yong,SUN Canbiao,ZHANG Guofei
  

  1. Department of Urology,Nanhai Hospital of Southern Medical University,Foshan 528244,China
  • Online:2020-12-25 Published:2021-01-19

摘要:

目的 评价保留前叶经尿道等离子前列腺剜除术(transurethral enucleation of prostate PKEP)对良性前列腺增生(benign prostatic hyperplasia,BPH)患者的 5 年疗效及安全性。方法 选取 100 BPH 患者,50 例行经尿道等离子前列腺电切术(PKRP 组),50 例行保留前叶 PKEP(PKEP 组)。比较 2 组患 者手术时间、术中出血量、切除组织重量、术后 3 个月至 5 年国际前列腺症状评分(I⁃PSS)、生活质量评分 QOL)、残余尿量(RUV)、最大尿流率(Qmax)的差异。结果 与PKRP组比较,PKEP组手术时间短、术中出 血量少、切除组织重量大(均 P < 0.001)。2 组患者 IPSS、RUV、QOL 在术后 3 个月、6 个月、1 年差异无统计 学意义(P>0.05);术后 3 年、5 PKEP 组优于 PKRP 组(P < 0.05)。PKEP 组患者术后各时期 Qmax 值均优 PKRP 组(P < 0.05)。IPSS、RUV、QOL、Qmax 值组内比较,PKEP 组内各时期差异均无统计学意义(P 0.05);PKRP 组内术后 1 年差异无统计学意义(P>0.05),但术后 3、5 年组内比较差异有统计学意义 P < 0.05)。结论 保留前叶 PKEP BPH 有效的治疗手段,手术时间缩短、术中出血量减少,并发症少, 解除排尿困难和下尿路症状效果好且稳定。

关键词:

Abstract:

Objective To evaluate the 5⁃year efficacy and safety of transurethral plasmakinetic enucleation of the prostate(PKEP)with anterior lobe preservation in the treatment of benign prostatic hyperplasia(BPH). Methods 100 patients with BPH were divided into two groups:transurethral plasmakinetic resection of prostate (PKRP group,n = 50)and PKEP preserving anterior lobe(PKEP group,n = 50). The operation time,intraopera⁃ tive blood loss,resected tissue weight,international prostate symptom score (I ⁃ PSS),quality of life score (QOL),residual urine volume(RUV)and maximum urinary flow rate(Qmax)3 months to 5 years after opera⁃ tion were compared between the two groups. Results compared with PKRP group,the operation time of PKEP group was shorter,the amount of intraoperative blood loss was less,and the weight of resected tissue was larger(all P < 0.001). There was no significant difference in IPSS,RUV and QOL between the two groups at 3 months,half a year and 1 year after operation,but 3 and 5 years after operation,the IPSS,RUV and QOL in the PKEP group were better than those in the PKRP group. The Qmax of PKEP group was better than that of PKRP group in all postoperative periods. There was no significant difference in IPSS,RUV,QOL and Qmax in each period in PKEP group(P > 0.05). There was no significant difference in PKRP group at 1 year after operation,but there was signifi⁃ cant difference in 3 years and 5 years after operation(P < 0.05). Conclusion Anterior lobe preserved PKEP is an effective treatment for BPH,with shorter operation time,less intraoperative blood loss and complications,and obvious and stable efficacy in relieving voiding obstruction and lower urinary tract symptoms.

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