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目的:比较经尿道等离子前列腺切除术(PKRP)与经尿道等离子前列腺剜除术(PKEP)治疗BPH的临床疗效及安全性。方法:回顾性分析2009年2月~2012年2月收治的318例BPH患者的临床资料,PKRP组151例,PKEP组167例。经直肠B超检查计算两组前列腺重量分别为28~169(77.5±22.5)g和31~176(82.3±24.7)g。比较两组之间手术时间、术中出血量、切除组织量、术后并发症等指标,以对比手术安全性;比较术前及术后3个月的最大尿流率(Qmax)、剩余尿量(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)等指标,以对比其临床疗效。结果:PKRP、PKEP组的平均手术时间分别为(87.3±16.5)min、(68.2±14.1)min,组间比较差异有统计学意义(P<0.05)。两组的术中平均出血量分别为(356.3±60.5)ml、(158.9±48.6)ml,组间比较差异有统计学意义(P<0.05)。两组平均切除组织质量分别为(34.2±11.7)g、(55.7±13.3)g,组间比较差异有统计学意义(P<0.05)。术后随访3个月,两组Qmax均较术前明显增加,术后IPSS、QOL、RUV均较术前明显下降,差异有统计学意义(P<0.05);两组术后各指标比较差异均无统计学意义(P>0.05)。两组术后暂时性尿失禁发生率、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:PKRP和PKEP两种手术方式治疗BPH均有明显临床疗效;但PKEP平均手术时间较短,术中出血量较少,切除增生腺体更干净彻底,安全性更高,具有更广的适用范围。
Objective: To compare the clinical efficacy and safety of transurethral plasmaphotonotectomy (PKRP) and transurethral plasmapapillary dissection (PKEP) in the treatment of BPH. Methods: The clinical data of 318 patients with BPH admitted from February 2009 to February 2012 were retrospectively analyzed. There were 151 patients in PKRP group and 167 patients in PKEP group. Transrectal ultrasound B calculated prostate weight were 28 ~ 169 (77.5 ± 22.5) g and 31 ~ 176 (82.3 ± 24.7) g. The operation time, intraoperative blood loss, amount of resected tissue and postoperative complications were compared between the two groups to compare the safety of operation. The maximal flow rate (Qmax), residual urine (RUV), International Prostate Symptom Score (IPSS) and Quality of Life Scale (QOL) were used to compare the clinical efficacy. Results: The average operation time of PKRP group and PKEP group were (87.3 ± 16.5) min and (68.2 ± 14.1) min, respectively. The difference between the two groups was statistically significant (P <0.05). The mean intraoperative blood loss in the two groups was (356.3 ± 60.5) ml and (158.9 ± 48.6) ml, respectively. There was significant difference between the two groups (P <0.05). The average quality of resected tissue in the two groups was (34.2 ± 11.7) g and (55.7 ± 13.3) g, respectively. The difference between the two groups was statistically significant (P <0.05). After 3 months of follow-up, the Qmax in both groups increased significantly compared with that before operation, and the IPSS, QOL and RUV after operation were significantly lower than those before operation (P <0.05). There were significant differences between the two groups No statistical significance (P> 0.05). There was no significant difference in incidence of temporary urinary incontinence and incidence of urethral stricture in 3 months (P> 0.05). Conclusion: Both PKRP and PKEP have obvious curative effect in the treatment of BPH. However, the average operation time of PKEP is shorter, the amount of blood loss in operation is less, the removal of proliferating glands is more thorough and clean, and has a wider application range.