摘要
目的:探讨经尿道等离子剜除术(TUPK-EP)治疗老年巨大良性前列腺增生(BPH)的效果和安全性。方法:回顾性分析2013年5月~2018年2月在我院接受治疗的巨大BPH患者的临床资料,根据治疗方法的不同分为2组,其中接受TUPK-EP治疗的患者63例(剜除组),接受经尿道等离子电切术(TUPK-RP)治疗的患者39例(电切组)。比较患者围手术期情况,术后并发症情况;术前术后最大尿流率(Qmax),膀胱残余尿量(RUV),国际前列腺症状评分(IPSS),以及术后勃起功能障碍、精液量减少和逆行射精发生情况。结果:剜除组手术时间明显缩短,术中冲洗液量明显减少,尿管留置时间明显缩短,切除组织重量明显大于电切组。两组术后继发出血、暂时性尿失禁、尿道口狭窄、尿漏等并发症比较差异无统计学意义。两组术后Qmax、Ruv和IPSS评分均较术前改善,剜除组术后Qmax大于电切组,Ruv小于电切组,IPSS评分低于电切组。剜除组术后勃起功能障碍和逆行射精发生率明显低于电切组,两组精液减少量比较差异无统计学意义。结论:TUPK-EP治疗老年巨大良性BPH,疗效确切、安全性高,对患者术后性功能的影响小。
Objective To investigate the efficacy and safety of TUPK-EP in treatment for elderly patients with large benign prostatic hyperplasia.Methods The clinical data of huge BPH patients treated in our hospital from May 2013 to February 2018 were retrospectively analyzed.According to the different treatment methods,all of the patients were divided into enucleation group(n=63)and resection group(n=39),and received transurethral plasma kinetic enucleation of the prostate(TUPK-EP)and transurethral plasma kinetic resection of the prostate(TUPK-RP).The perioperative period and postoperative complications were observed,and the maximum urine flow rate(Qmax)and the residual urinary bladder(RUV)were compared before and after the treatment.The changes of International Prostate Symptom Score(IPSS)before and after treatment were compared,and the incidence of erectile dysfunction,semen volume reduction and retrograde ejaculation were observed.Results The operation time of the enucleation group was significantly shortened,the amount of rinse fluid was significantly reduced,the indwelling time of the catheter was significantly shortened,and the weight of the excised tissue was significantly greater than that of the resection group.There was no significant difference in secondary hemorrhage,urinary incontinence,urethral stricture and urinary leakage in the two groups.The Qmax,Ruv and IPSS in the two groups were better than those before treatment.The Qmax of the enucleation group was greater than that of the resection group,the Ruv was less than that of the resection group,and the IPSS score was lower than that of the resection group.The incidence of erectile dysfunction and retrograde ejaculation in the enucleation group was significantly lower than that in the resection group.There was no significant difference in the reduction of semen in the two groups.Conclusion TUPK-EP is effective and safe in the treatment of elderly patients with giant benign BPH,and has little effect on postoperative sexual function.
作者
付阳
孙青
Fu Yang;Sun Qing(Dep of Urology,Huaian First People's Hospital,Huaian 223300,China)
出处
《湖南师范大学学报（医学版）》
2019年第6期113-115,共3页
Journal of Hunan Normal University(Medical Sciences)
关键词
经尿道等离子剜除术
经尿道等离子电切术
巨大良性前列腺增生
transurethral plasma kinetic enucleation of the prostate
transurethral plasma kinetic resection of the prostate
giant benign BPH
