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目的对比分析经尿道双极等离子前列腺电切术(PKRP)和前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的疗效及并发症。方法回顾性分析2007年1月至2008年1月我院收治的BPH患者303例,PKRP组143例,年龄(74.0±12.4)岁,前列腺体积(75.6±13.5)ml;PKEP组160例,年龄(76.0±15.5)岁,前列腺体积(77.3±12.5)ml。比较两组患者手术时间、术中出血量、切除组织量、留置尿管时间、住院时间及手术并发症发生率及疗效。结果两组术后残余尿量、IPSS评分、生活质量评分、最大尿流率术后与术前比较,差异均有统计学意义(P<0.05),两组术后比较差异均无统计学意义(P>0.05)。两组术中出血量,2个月内暂时性尿失禁发生率比较差异均有统计学意义(P<0.05)。两组手术时间、切除组织量、留置尿管时间、住院时间、继发性出血发生率、3个月内尿道狭窄发生率比较差异均无统计学意义(P>0.05)。结论两种术式治疗BPH均有满意疗效,但PKEP在术中出血量和2个月内暂时性尿失禁发生率方面更有优势,值得推广应用。
Objective To compare the efficacy and complications of transurethral bipolar plasmakinetic prostatectomy (PKRP) and prostatectomy (PKEP) in the treatment of benign prostatic hyperplasia (BPH). Methods A total of 303 BPH patients were treated in our hospital from January 2007 to January 2008, 143 patients in PKRP group (74.0 ± 12.4) and prostate volume (75.6 ± 13.5) ml, PKEP group (160 patients), age (76.0 ± 15.5) years old and prostate volume (77.3 ± 12.5) ml. The operation time, intraoperative blood loss, amount of resected tissue, indwelling catheter time, hospitalization time and operative complication rate and efficacy were compared between the two groups. Results The postoperative residual urine volume, IPSS score, quality of life score and maximal uroflow rate were significantly different between the two groups (P <0.05), but there was no significant difference between the two groups (P> 0.05). There was significant difference in the incidence of intraoperative blood loss and transient urinary incontinence within two months (P <0.05). There was no significant difference in the incidence of urethral stricture between the two groups (P> 0.05). There was no significant difference between the two groups in the operation time, the amount of resected tissue, the length of indwelling catheter, the length of hospital stay, the incidence of secondary hemorrhage and the incidence of urethral stricture within 3 months. Conclusions Two kinds of surgical treatment of BPH have satisfactory curative effect. However, PKEP has more advantages in intraoperative blood loss and incidence of transient urinary incontinence within 2 months, which is worth popularizing and applying.