[铲状电极经尿道等离子体动力前列腺剜除术与等离子体动力前列腺切除术治疗良性前列腺增生症的比较]

[Shovel-shaped electrode transurethral plasmakinetic enucleation versus plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia].

作者信息

Zhao Lin, Ma Yong-Hong, Chen Qi, Chen Yan-Bo, Gu Meng, Gao Jing-Feng, Zhang Guang-Tao, Mou Jiang-Ning, Bao Zhen-Hu, Wang Zhong

机构信息

Departments of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.

Departments of Urology, Shizuishan Second People's Hospital, Shizuishan, Ningxia 753000, China.

出版信息

Zhonghua Nan Ke Xue. 2018 Feb;24(2):133-137.

PMID:30156072

Abstract

OBJECTIVE

To compare the safety and effectiveness of shovel-shaped electrode transurethral plasmakinetic enucleation of the prostate (PKEP) with those of plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH).

METHODS

We retrospectively analyzed the clinical data about 78 BPH patients received in Shanghai Ninth People's Hospital from June 2016 to January 2017, 39 treated by shovel-shaped electrode PKEP and the other 39 by PKRP. We observed the patients for 6 months postoperatively and compared the effects and safety of the two surgical strategies.

RESULTS

No statistically significant difference was observed between the PKEP and PKRP groups in the operation time (［69.3 ± 8.8］ vs ［72.2 ± 7.9］ min, P = 0.126), but the former, as compared with the latter, showed a markedly less postoperative loss of hemoglobin (［3.9 ± 2.8］ vs ［13.9 ± 5.2］ g/L, P <0.001) and shorter bladder irrigation time (［12.5 ± 1.2］ vs ［43.4 ± 2.8］ h, P <0.001), catheterization time (［64.0 ± 4.5］ vs ［84.8 ± 3.0］ h, P <0.001) and hospital stay (［3.1 ± 0.3］ vs ［5.5 ± 0.4］ d, P <0.001). There were no statistically significant differences between the PKEP and PKRP groups in the postoperative maximum urinary flow rate (Qmax) (［21.62 ± 1.07］ vs ［21.03 ± 0.96］ ml/s, P = 0.12), International Prostate Symptoms Score (IPSS) (5.85 ± 0.90 vs 6.03 ± 0.81, P = 0.279), quality of life score (QoL) (2.0 ± 0.73 vs 2.28 ± 0.72, P = 0.09), postvoid residual urine volume (PVR) (［19.59 ± 6.01］ vs ［20.21 ± 5.16］ ml, P = 0.629), or the incidence rates of urinary incontinence (2.56% ［1/39］ vs 7.69% ［3/39］, P >0.05) and other postoperative complications.

CONCLUSIONS

Both PKEP and PKRP are effective methods for the treatment of BPH, but PKEP is worthier of clinical recommendation for a better safety profile, more thorough removal of the prostate tissue, less blood loss, shorter hospital stay, and better improved quality of life of the patient.

摘要

目的

比较铲状电极经尿道等离子体动力前列腺剜除术（PKEP）与等离子体动力前列腺切除术（PKRP）治疗良性前列腺增生（BPH）的安全性和有效性。

方法

回顾性分析2016年6月至2017年1月在上海第九人民医院收治的78例BPH患者的临床资料，其中39例行铲状电极PKEP治疗，另外39例行PKRP治疗。术后对患者进行6个月的观察，比较两种手术方式的效果和安全性。

结果

PKEP组与PKRP组手术时间比较差异无统计学意义（［69.3±8.8］ vs ［72.2±7.9］分钟，P = 0.126），但与PKRP组相比，PKEP组术后血红蛋白丢失明显较少（［3.9±2.8］ vs ［13.9±5.2］g/L，P <0．001），膀胱冲洗时间较短（［12.5±1.2］ vs ［43.4±2.8］小时，P <0.001），导尿时间较短（［64.0±4.5］ vs ［84.8±3.0］小时，P <0.001），住院时间较短（［3.1±0.3］ vs ［5.5±0.4］天，P <0.001）。PKEP组与PKRP组术后最大尿流率（Qmax）（［21.62±1.07］ vs ［21.03±0.96］ml/s，P = 0.12）、国际前列腺症状评分（IPSS）（5.85±0.90 vs 6.03±0.81，P = 0.279）、生活质量评分（QoL）（2.0±0.73 vs 2.28±0.72，P = 0.09）、残余尿量（PVR）（［19.59±6.01］ vs ［20.21±5.16］ml，P = 0.629）或尿失禁发生率（2.56%［１/39］ vs 7.69%［3/39］，P>0.05）及其他术后并发症发生率比较差异均无统计学意义。