经尿道等离子血供预断式前列腺三分区法剜切术的临床观察*

Plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance*

摘要:

目的 观察经尿道等离子血供预断式前列腺三分区法剜切术（PKERPDPB）治疗前列腺增生（BPH）的安全性和疗效。方法 158例患者，随机分成两组，观察组81例采用PKERPDPB，对照组77例采用经尿道等离子电切术（PKRP），比较两组手术时间、切除前列腺组织重量、术中出血量、术后导尿管留置时间、住院时间及术中并发症。术后随访12个月，比较两组患者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）及远期手术并发症等指标的变化。结果 两组患者平均年龄、术前前列腺体积、IPSS、QOL及PVR差异均无统计学意（P >0.05），观察组及对照组切除前列腺组织重量分别为（61.8±10.5）和（32.5±12.6）g；术中出血量分别为（98.7±15.8）和（160.5±16.5）ml；术后导尿管留置时间分别为（5.3±0.8）和（7.5±1.2）d；住院时间分别为（5.8±1.6）和（8.8±1.5）d，差异均有统计学意义（P <0.05）。随访至12个月时，两组IPSS、QOL和Qmax术后较术前明显改善，差异有统计学意义（P <0.01）。两组之间术后IPSS、QOL、Qmax及PVR相比差异无统计学意义（P >0.05）。结论 PKERPDPB相比传统PKRP，疗效相似，但切除组织更彻底，术中出血更少，术后导尿管留置时间及住院时间更短，安全有效。

Abstract:

Objective To investigate the efficacy and safety of plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB). Methods 158 patients with BPH were randomly divided two groups: 81 patients treated by plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB), 77 patients treated by plasmakinetic resection of the prostate (PKRP). All patients were evaluated preoperatively and at 1, 6, 12 months after surgery by IPSS, QOL, Qmax and PVR. Operation time, resected adenoma weight, catheterization time, hospital stay and complications were documented. Results There were no significant differences in preoperative parameters. The resected adenoma weight in the PKERPADPB group was heavier than that in the PKRP group, the difference was significant. Compared with PKRP, PKERPDPB required a longer operation time, but resulted in less hemoglobin decrease, less catheterization time and hospital time. During the 1, 6, 12 months of follow-up, there was no significant difference in Qmax, IPSS, PVR and QOL between the groups. Conclusion PKERPDPB was statistically superior to PKRP in blood loss, catheterization time, hospital stay but inferior in operation time. It was a safe and effective treatment for BPH.