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经尿道前列腺剜除术与经尿道前列腺切除术治疗良性前列腺增生症的对比

[Transurethral enucleative resection of the prostate versus transurethral resection of the prostate for benign prostate hyperplasia].

作者信息

Zuo Wei, Wang Zhen-Zhong, Xue Jun

出版信息

Zhonghua Nan Ke Xue. 2014 Sep;20(9):812-5.

Abstract

OBJECTIVE

To compare the effectiveness and safety of transurethral resection of the prostate (TURP) and transurethral enucleative resection of the prostate (TUERP) in the treatment of benign prostate hyperplasia (BPH).

METHODS

A total of 630 BPH patients with indication of surgery were randomly assigned to receive TURP (n = 305) and TUERP (n = 325), respectively. There were no significant differences preoperatively in age, prostate volume, International Prostate Symptom Score (IPSS), and Qmax between the two groups (P > 0.05). The prostate resection rate, operation time, postoperative complications, and quality of life (QOL) of the patients were recorded and statistically analyzed.

RESULTS

Compared with TURP, TUERP showed a significantly higher rate of prostate resection ([47.0 +/- 13.3] vs [60.1 +/- 12.3]%, P < 0.05), shorter operation time ([57.9 +/- 15.9] vs [40.4 +/- 14.2] min, P < 0.05), and shorter bladder irrigation time ([2.7 +/- 0.6] vs [2.2 + 1.1] d, P < 0.05). Significant differences were found between the pre- and post-operative levels of serum sodium and hemoglobin in the TURP group ([141.2 +/- 3.5 ] vs [136.9 +/- 4.7] mmol/L, P < 0.01; [137.6 +/- 8.8] vs [124.8 +/- 9.6] g/L, P < 0.01), but not in the TUERP group. Three months after operation, IPSS, QOL, and Qmax were all markedly improved in both groups (P < 0.01), but with no significant differences between the two groups (P >0.05).

CONCLUSION

TUERP is better than TURP in the treatment of BPH for its advantages of higher resection rate of the prostate, shorter operation time and bladder irrigation time, less intraoperative blood loss, fewer postoperative complications, and faster recovery.

摘要

目的

比较经尿道前列腺电切术(TURP)和经尿道前列腺剜除术(TUERP)治疗良性前列腺增生(BPH)的有效性和安全性。

方法

将630例有手术指征的BPH患者随机分为两组,分别接受TURP(n = 305)和TUERP(n = 325)治疗。两组患者术前年龄、前列腺体积、国际前列腺症状评分(IPSS)及最大尿流率(Qmax)比较,差异均无统计学意义(P > 0.05)。记录并统计分析患者的前列腺切除率、手术时间、术后并发症及生活质量(QOL)。

结果

与TURP相比,TUERP的前列腺切除率显著更高([47.0±13.3]% 对 [60.1±12.3]%,P < 0.05),手术时间更短([57.9±15.9]分钟 对 [40.4±14.2]分钟,P < 0.05),膀胱冲洗时间更短([2.7±0.6]天 对 [2.2±1.1]天,P < 0.05)。TURP组术后血清钠和血红蛋白水平与术前比较差异有统计学意义([141.2±3.5]毫摩尔/升 对 [136.9±4.7]毫摩尔/升,P < 0.01;[137.6±8.8]克/升 对 [124.8±9.6]克/升,P < 0.01),而TUERP组差异无统计学意义。术后3个月,两组患者的IPSS、QOL及Qmax均明显改善(P < 0.01),但两组间差异无统计学意义(P > 0.05)。

结论

TUERP治疗BPH优于TURP,具有前列腺切除率高、手术时间和膀胱冲洗时间短、术中出血少、术后并发症少及恢复快等优点。

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