目的比较经尿道前列腺等离子剜除术(PKEP)与经尿道前列腺等离子双极电切术(PKRP)两种术式治疗良性前列腺增生的安全性和有效性。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和万方数据...目的比较经尿道前列腺等离子剜除术(PKEP)与经尿道前列腺等离子双极电切术(PKRP)两种术式治疗良性前列腺增生的安全性和有效性。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和万方数据库,查找所有比较PKEP和PKRP治疗良性前列腺增生症的随机对照试验(RCT),检索时限均为建库至2011年3月31日。同时手检纳入文献的参考文献。按纳入排除标准由两人独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析,并采用GRADE系统进行证据质量评价。结果共纳入8个研究,991例患者。Meta分析结果显示:①在安全性方面:与PKRP相比,PKEP手术时间较短[SMD=1.07,95%CI(0.19,1.94),P=0.02]、术中出血量较少[SMD=2.06,95%CI(1.42,2.69),P<0.01]、切除腺体量较多[SMD=–0.91,95%C(I–1.33,–0.48),P<0.0001]、外科包膜穿孔较少[RR=4.48,95%C(I1.43,14.02),P=0.01]、术后留置导尿时间较短[SMD=1.98,95%CI(0.39,3.57),P=0.01]、膀胱冲洗时间较短[SMD=3.49,95%CI(0.51,6.47),P=0.02]、住院天数较短[SMD=0.89,95%CI(0.64,1.13),P<0.01]、术后总并发症差异无统计学意义[RR=0.82,95%CI(0.54,1.24),P=0.35];②在有效性方面:术后3月PKEP的IPSS评分低于PKRP,QOL评分高于PKRP;术后6月RUV的改善PKEP优于PKRP;其它术后3月和6月组间指标差异均无统计学意义(P>0.05)。基于系统评价结果,采用GRADE系统推荐分级方法评价证据质量及推荐等级,结果显示,证据水平均为低级,推荐强度为弱推荐。结论 PKEP和PKRP两种术式相比,疗效相似,但PKEP术中切除增生腺体更干净彻底,相对手术时间却较短,出血较少,安全性更高;但因原始研究的质量均较低,建议临床上审慎选择使用;需要更多高质量、大样本的RCT进一步论证。展开更多
目的比较经尿道等离子双极电切术(B-TURP)与传统单极电切术(M-TURP)两种术式治疗良性前列腺增生症的安全性和有效性。方法计算机检索MEDLINE、EMBASE、Web of Science及CNKI电子数据库,查找所有比较B-TURP和M-TURP治疗良性前列腺增生症...目的比较经尿道等离子双极电切术(B-TURP)与传统单极电切术(M-TURP)两种术式治疗良性前列腺增生症的安全性和有效性。方法计算机检索MEDLINE、EMBASE、Web of Science及CNKI电子数据库,查找所有比较B-TURP和M-TURP治疗良性前列腺增生症的随机对照试验(RCT),同时手检纳入文献的参考文献。按纳入排除标准由2人独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.0软件进行Meta分析。结果共纳入6个研究,718例患者。Meta分析结果显示:1安全性方面:与M-TURP相比,B-TURP后血钠(MD:-3.96,95%CI:-6.70,-1.22,P<0.05)及血红蛋白(MD:-0.48,95%CI:-0.58,-0.38,P<0.000 01)下降值较低;发生TURS的患者较少(B-TURP组0例,M-TURP组3例);尿道狭窄、尿潴留、尿失禁等并发症的发生率差异无统计学意义。2有效性方面:国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿(PVR)、手术时长及术中切除前列腺组织重量的差异均无统计学意义。结论与M-TURP术相比,B-TURP具有相似的有效性和更高的安全性。展开更多
In a community-based study, the relationship between age and human prostate size was investigated in a population of men between the ages of 40 and 70 years to determine the normal prostate increase curve equation. On...In a community-based study, the relationship between age and human prostate size was investigated in a population of men between the ages of 40 and 70 years to determine the normal prostate increase curve equation. One thousand male volunteers were randomly recruited from the Shanghai community, and the length, width, height, volume of the transition zone （TZ） and the whole prostates were measured by transrectal ultrasound （TRUS）. Each volunteer was evaluated bythe International Prostate Symptom Score （IPSS）. Among those who completed the examination, the mean prostate parameters were all positively associated with increased age. There were statistically significant differences between each age group （P〈O.05）. The mean transition zone volume （TZV） had a higher increase rate with age than the mean total prostate volume （TPV）, indicating that the enlargement of the TZ contributed the most to the increase in TPV. While all prostate parameters were positively correlated with the IPSS, the strongest correlation was associated with the TZ length （TZL） and TZV. The growth curve equations for prostate width, height and length were also positively associated with increasing展开更多
目的比较经尿道刀口变向钬激光前列腺剜除术(turning holmium laser enucleation of prostate,THolEP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)+膀胱颈切开术(transurethral incision of bladder neck,TUIBN)...目的比较经尿道刀口变向钬激光前列腺剜除术(turning holmium laser enucleation of prostate,THolEP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)+膀胱颈切开术(transurethral incision of bladder neck,TUIBN)治疗小体积前列腺增生(benign prostatic hyperplasia,BPH)的疗效和安全性。方法选取2019年1月至2020年1月在我院手术治疗的小体积BPH患者65例,随机分为两组,分别行THolEP术(THolEP组,33例)和TURP+TUIBN术(TURP+TUIBN组,32例)。比较两组手术指标及术后1、3、6、12、18个月国际前列腺症状评分(international prostate symptom score,IPSS),生活质量(quality of life,QOL)评分,最大尿流率(Qmax),残余尿量(residual urine volume,RUV)及术后逆行射精发生率。结果两组手术均顺利完成,均未发生电切综合征。THolEP组术中切除组织量大于TURP+TUIBN组(P<0.05),而两组手术时间、术中出血量比较,差异无统计学意义(P>0.05)。THolEP组和TURP+TUIBN组术中发生前列腺包膜穿孔分别为1例和6例,术后1周发生压力性尿失禁分别为2例和8例,组间比较差异有统计学意义(P<0.05)。行盆底肌收缩训练3个月后两组均无尿失禁病例。术后2个月TURP+TUIBN组1例出现尿道狭窄,定期进行尿道扩张后缓解。两组患者均于术后1、3、6、12、18个月进行随访。两组术后各时点IPSS、QOL、Qmax及RUV均较术前明显改善(P<0.05);组间比较,THolEP组术后各时点上述指标均明显优于TURP+TUIBN组(P<0.05)。术后6、12、18个月随访逆行射精发生率,TURP+TUIBN组分别为31.3%、28.1%及28.1%,明显高于THolEP组的9.1%(P<0.05)。结论THolEP肌层无损伤解剖性松解膀胱颈治疗小体积BPH,疗效确切,症状缓解明显,并发症少,值得临床推广。展开更多
文摘目的比较经尿道前列腺等离子剜除术(PKEP)与经尿道前列腺等离子双极电切术(PKRP)两种术式治疗良性前列腺增生的安全性和有效性。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和万方数据库,查找所有比较PKEP和PKRP治疗良性前列腺增生症的随机对照试验(RCT),检索时限均为建库至2011年3月31日。同时手检纳入文献的参考文献。按纳入排除标准由两人独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析,并采用GRADE系统进行证据质量评价。结果共纳入8个研究,991例患者。Meta分析结果显示:①在安全性方面:与PKRP相比,PKEP手术时间较短[SMD=1.07,95%CI(0.19,1.94),P=0.02]、术中出血量较少[SMD=2.06,95%CI(1.42,2.69),P<0.01]、切除腺体量较多[SMD=–0.91,95%C(I–1.33,–0.48),P<0.0001]、外科包膜穿孔较少[RR=4.48,95%C(I1.43,14.02),P=0.01]、术后留置导尿时间较短[SMD=1.98,95%CI(0.39,3.57),P=0.01]、膀胱冲洗时间较短[SMD=3.49,95%CI(0.51,6.47),P=0.02]、住院天数较短[SMD=0.89,95%CI(0.64,1.13),P<0.01]、术后总并发症差异无统计学意义[RR=0.82,95%CI(0.54,1.24),P=0.35];②在有效性方面:术后3月PKEP的IPSS评分低于PKRP,QOL评分高于PKRP;术后6月RUV的改善PKEP优于PKRP;其它术后3月和6月组间指标差异均无统计学意义(P>0.05)。基于系统评价结果,采用GRADE系统推荐分级方法评价证据质量及推荐等级,结果显示,证据水平均为低级,推荐强度为弱推荐。结论 PKEP和PKRP两种术式相比,疗效相似,但PKEP术中切除增生腺体更干净彻底,相对手术时间却较短,出血较少,安全性更高;但因原始研究的质量均较低,建议临床上审慎选择使用;需要更多高质量、大样本的RCT进一步论证。
文摘目的比较经尿道等离子双极电切术(B-TURP)与传统单极电切术(M-TURP)两种术式治疗良性前列腺增生症的安全性和有效性。方法计算机检索MEDLINE、EMBASE、Web of Science及CNKI电子数据库,查找所有比较B-TURP和M-TURP治疗良性前列腺增生症的随机对照试验(RCT),同时手检纳入文献的参考文献。按纳入排除标准由2人独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.0软件进行Meta分析。结果共纳入6个研究,718例患者。Meta分析结果显示:1安全性方面:与M-TURP相比,B-TURP后血钠(MD:-3.96,95%CI:-6.70,-1.22,P<0.05)及血红蛋白(MD:-0.48,95%CI:-0.58,-0.38,P<0.000 01)下降值较低;发生TURS的患者较少(B-TURP组0例,M-TURP组3例);尿道狭窄、尿潴留、尿失禁等并发症的发生率差异无统计学意义。2有效性方面:国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿(PVR)、手术时长及术中切除前列腺组织重量的差异均无统计学意义。结论与M-TURP术相比,B-TURP具有相似的有效性和更高的安全性。
文摘In a community-based study, the relationship between age and human prostate size was investigated in a population of men between the ages of 40 and 70 years to determine the normal prostate increase curve equation. One thousand male volunteers were randomly recruited from the Shanghai community, and the length, width, height, volume of the transition zone （TZ） and the whole prostates were measured by transrectal ultrasound （TRUS）. Each volunteer was evaluated bythe International Prostate Symptom Score （IPSS）. Among those who completed the examination, the mean prostate parameters were all positively associated with increased age. There were statistically significant differences between each age group （P〈O.05）. The mean transition zone volume （TZV） had a higher increase rate with age than the mean total prostate volume （TPV）, indicating that the enlargement of the TZ contributed the most to the increase in TPV. While all prostate parameters were positively correlated with the IPSS, the strongest correlation was associated with the TZ length （TZL） and TZV. The growth curve equations for prostate width, height and length were also positively associated with increasing
