[1]冯友亮.经尿道等离子前列腺剜除术治疗大体积前列腺增生的疗效[J].医学信息,2020,33(01):109-112.[doi:10.3969/j.issn.1006-1959.2020.01.033]
　FENG You-liang.Effect of Transurethral Plasma Kinetic Enucleation of Prostate for Large-volume Prostatic Hyperplasia[J].Medical Information,2020,33(01):109-112.[doi:10.3969/j.issn.1006-1959.2020.01.033]
点击复制

经尿道等离子前列腺剜除术治疗大体积前列腺增生的疗效()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年01期
页码:
109-112
栏目:
临床研究
出版日期:
2020-01-01

文章信息/Info

Title:
Effect of Transurethral Plasma Kinetic Enucleation of Prostate for Large-volume Prostatic Hyperplasia
文章编号:
1006-1959（2020）01-0109-04
作者:
冯友亮
（佳木斯市中心医院泌尿外科，黑龙江 佳木斯 154002）
Author(s):
FENG You-liang
(Department of Urology,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)
关键词:
良性前列腺增生; 经尿道等离子前列腺剜除术; 经尿道等离子前列腺电切术
Keywords:
Large-volume benign prostatic hyperplasia; benign prostatic hyperplasia; transurethral plasma kinetic enucleation of prostate; transurethral plasma kinetic resection of prostate
分类号:
R697+.32
DOI:
10.3969/j.issn.1006-1959.2020.01.033
文献标志码:
A
摘要:
目的 探讨经尿道等离子前列腺剜除术（TPKEP）治疗大体积良性前列腺增生的疗效。方法 收集2016年3月~2018年1月佳木斯市中心医院泌尿外科收治的大体积前列腺增生患者126例，根据治疗方法分为对照组（58例）和观察组（68例）。对照组采用经尿道等离子前列腺电切术（TPKRP）治疗，观察组采用TPKEP治疗，比较两组围手术期指标（手术时间、术中出血量、前列腺切除重量、膀胱冲洗时间、留置尿管时间、术后住院时间）及术前、术后3、12个月IPSS评分、QOL评分、最大尿流率（Qmax）、残余尿量（RUV）和术后并发症发生情况。结果 观察组手术时间、术中出血量、前列腺切除重量均优于对照组[（75.12±38.18）min vs（90.50±45.66）min]、[（98.33±26.71）ml vs（117.32±34.70）ml]、[（53.82±8.05）g vs（41.80±6.77）g]，差异有统计学意义（P＜0.05）；两组膀胱冲洗时间、尿管留置时间、术后住院时间比较，差异无统计学意义（P＞0.05）。两组术后3、12个月IPSS评分、QOL评分较术前降低，Qmax较术前增高，RUV较术前减少，差异有统计学意义（P＜0.05）。观察组术后3个月QOL评分高于对照组，RUV低于对照组，差异有统计学意义（P＜0.05）；两组术后3个月IPSS评分、Qmax比较，差异无统计学意义（P＞0.05）。观察组术后12个月Qmax高于对照组，RUV低于对照组，差异有统计学意义（P＜0.05）；两组术后12个月IPSS评分、QOL评分比较，差异无统计学意义（P＞0.05）。观察组术后3、12个月并发症总发生率低于对照组，差异有统计学意义（P＜0.05）。结论 TPKEP治疗大体积前列腺增生临床疗效确切，可有效缩短手术时间、减少术中出血量、收割更多的增生腺体组织，达到满意的排尿功能，有助于改善患者术后的生活质量，且并发症的发生率较低，具有较高的临床应用价值。
Abstract:
Objective To investigate the efficacy of transurethral plasma kinetic enucleation of prostate(TPKEP) for large-volume benign prostatic hyperplasia. Methods A total of 126 patients with large benign prostatic hyperplasia treated in the Urology Department of Jiamusi Central Hospital from March 2016 to January 2018 were collected and divided into the control group (58 cases) and the observation group (68 cases) according to the treatment method. The control group was treated with transurethral plasma kinetic resection of prostate (TPKRP), and the observation group was treated with TPKEP.The perioperative indexes (operation time, intraoperative bleeding volume, prostate resection weight, bladder flushing time, indwelling catheter time, postoperative hospitalization time) and preoperative, postoperative 3 and 12 months IPSS score, QOL score, maximum urinary flow rate (Qmax), residual urine volume (RUV) and postoperative complications were compared between the two groups.Results The observation group had better operation time, intraoperative blood loss, and prostate resection weight than the control group [(75.12±38.18) min vs (90.50±45.66) min], [(98.33±26.71) ml vs (117.32±34.70) ml], [(53.82±8.05) g vs (41.80±6.77) g], the difference was statistically significant (P<0.05); there was no statistically significant difference in bladder irrigation time, urinary indwelling time, and postoperative hospital stay between the two groups (P>0.05). At 3 and 12 months after surgery, the IPSS score and QOL score of the two groups were lower than before surgery, Qmax was higher than before surgery, and RUV was lower than before surgery,the difference was statistically significant (P<0.05). The QOL score of the observation group at 3 months after operation was higher than that of the control group, and the RUV was lower than that of the control group, the difference was statistically significant (P<0.05). There was no significant difference in the IPSS score and Qmax at 3 months after operation between the two groups(P>0.05). The Qmax of the observation group at 12 months after operation was higher than that of the control group, and the RUV was lower than that of the control group, the difference was statistically significant (P<0.05). There was no significant difference in IPSS score and QOL score between the two groups after 12 months (P>0.05). The total incidence of complications in the observation group at 3 and 12 months after surgery was lower than that in the control group,the difference was statistically significant (P<0.05). Conclusion TPKEP is effective in treating large-volume benign prostatic hyperplasia, which can effectively shorten the operation time, reduce the amount of intraoperative blood loss, harvest more proliferative glandular tissues, and achieve satisfactory urination function, which can help improve the surgical operation quality of life and low incidence of complications, it has high clinical application value.

参考文献/References:

[1]郝炜,云志中,马可为.双极等离子前列腺剜除术与电切术治疗前列腺增生症的随机对照研究[J].临床和实验医学杂志,2017,16(4):388-390. [2]江敦勤.经尿道双极等离子前列腺剜除术治疗良性前列腺增生症效果观察[J].山东医药,2016,56(46):97-99. [3]王世先,杨水法,杨恩明,等.不同前列腺体积采用经尿道双极等离子电切术与剜除术治疗的前瞻性对比研究(附521例报告)[J].微创泌尿外科杂志,2016,5(3):145-149. [4]巩向文,刘伟光,高佃军,等.经尿道双极等离子前列腺剜除术与电切术术后尿失禁发生率比较[J].青岛大学医学院学报,2016,52(3):352-354,358. [5]Foo KT.What is a disease?What is the disease clinical benign prostatic hyperplasia (BPH)[J].World Journal of Urology,2019,37(7):1293-1296. [6]Abou-Taleb A,El-Shaer W,Kandeel W,et al.Bipolar Plasmakinetic Enucleoresection of the Prostate:Our Experience with 245 Patients for 3 Years of Follow-Up[J].Journal of Endourology,2017,31(3):300-306. [7]Wang Z,Zhang J,Zhang H,et al.Impact on sexual function of plasma button transurethral vapour enucleation versus plasmakinetic resection of the large prostate ＞90 ml:Results of a prospective, randomized trial[J].Andrologia,2019:e13390. [8]Samir M,Tawfick A,Mahmoud MA,et al.Two-year Follow-up in Bipolar Transurethral Enucleation and Resection of the Prostate in Comparison with Bipolar Transurethral Resection of the Prostate in Treatment of Large Prostates. Randomized Controlled Trial[J].Urology,2019(133):192-198. [9]刘俊峰,谭朝晖,李星智,等.经尿道双极等离子电切术治疗80 ml以上前列腺增生的疗效分析[J].重庆医学,2015.44(6):795-797. [10]Giulianelli R,Gentile BC,Mirabile G,et al.Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia:a single centre 3-year comparison[J].Prostate Cancer and Prostatic Diseases,2019,22(1):110-116. [11]Mordasini L,Moschini M,Mattei A,et al.Green light laser for benign prostatic hyperplasia[J].Current Opinion in Urology,2018,28(3):322-328. [12]Gratzke C,Bachmann A,Descazeaud A,et al.EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction[J].European Urology,2015,67(6):1099-1109. [13]Elkoushy MA,Elshal AM,Elhilali MM.Postoperative lower urinary tract storage symptoms:does prostate enucleation differ from prostate vaporization for treatment of symptomatic benign prostatic hyperplasia[J].Journal of Endourology,2015,29(10):1159-1165. [14]Kim KS,Lee SH,Cho HJ,et al.Comparison of Bipolar Plasma Vaporization versus Standard Holmium Laser Enucleation of the Prostate:Surgical Procedures and Clinical Outcomes for Small Prostate Volumes[J].Journal of Clinical Medicine,2019,8(7):E1007. [15]张振丰.经尿道前列腺等离子剜除术对大体积前列腺增生的治疗效果[J].河南医学研究,2019(16):2937-2938. [16]Wei Y,Xu N,Chen SH,et al.Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr:A retrospective study at a single academic tertiary care center[J].International Brazilian Journal of Urology,2016,42(4):747-756.

相似文献/References:

[1]张细初.良性前列腺增生患者手术前后尿动力学检查的应用价值[J].医学信息,2018,31(23):124.[doi:10.3969/j.issn.1006-1959.2018.23.034]
　ZHANG Xi-chu.The Value of Urodynamic Examination before and after Operation in Patients with Benign Prostatic Hyperplasia[J].Medical Information,2018,31(01):124.[doi:10.3969/j.issn.1006-1959.2018.23.034]
[2]谭宏宇,祝清国.当代前列腺动脉栓塞术的文献回顾[J].医学信息,2019,32(06):48.[doi:10.3969/j.issn.1006-1959.2019.06.017]
　TAN Hong-yu,ZHU Qing-guo.Literature Review of Contemporary Prostate Artery Embolization[J].Medical Information,2019,32(01):48.[doi:10.3969/j.issn.1006-1959.2019.06.017]
[3]孙晓峰.经尿道前列腺钬激光剜除术治疗良性前列腺增生的临床效果[J].医学信息,2019,32(20):108.[doi:10.3969/j.issn.1006-1959.2019.20.031]
　SUN Xiao-feng.Clinical Effect of Transurethral Resection of the Prostate and Laser for the Treatment of Benign Prostatic Hyperplasia[J].Medical Information,2019,32(01):108.[doi:10.3969/j.issn.1006-1959.2019.20.031]
[4]马志远.TURP与TUVP治疗良性前列腺增生的疗效比较[J].医学信息,2020,33(07):115.[doi:10.3969/j.issn.1006-1959.2020.07.035]
　MA Zhi-yuan.Comparison of Curative Effect Between TURP and TUVP in the Treatment of Benign Prostatic Hyperplasia[J].Medical Information,2020,33(01):115.[doi:10.3969/j.issn.1006-1959.2020.07.035]
[5]何 靖,王海洋,肖嘉伍,等.经皮膀胱造瘘输尿管镜钬激光碎石联合TURP在BPH合并膀胱结石中的应用[J].医学信息,2020,33(16):112.[doi:10.3969/j.issn.1006-1959.2020.16.034]
　HE Jing,WANG Hai-yang,XIAO Jia-wu,et al.Application of Percutaneous Cystostomy and Ureteroscope Holmium Laser Lithotripsy Combined with TURP in the Treatment of BPH Complicated with Bladder Stones[J].Medical Information,2020,33(01):112.[doi:10.3969/j.issn.1006-1959.2020.16.034]
[6]罗杰鑫,卢远生,方少伟,等.良性前列腺增生电切术后再行钬激光剜除术的临床效果[J].医学信息,2020,33(24):101.[doi:10.3969/j.issn.1006-1959.2020.24.027]
　LUO Jie-xin,LU Yuan-sheng,FANG Shao-wei,et al.Clinical Effect of Holmium Laser Enucleation After Electroresection of Benign Prostatic Hyperplasia[J].Medical Information,2020,33(01):101.[doi:10.3969/j.issn.1006-1959.2020.24.027]
[7]赵 鹏,杨 妮,胡黄金,等.升降通癃方在良性前列腺增生治疗中的应用[J].医学信息,2021,34(24):147.[doi:10.3969/j.issn.1006-1959.2021.24.038]
[8]吴 洋.不同手术方式治疗良性前列腺增生的效果[J].医学信息,2022,35(03):109.[doi:10.3969/j.issn.1006-1959.2022.03.026]
　WU Yang.Effect of Different Surgical Methods in the Treatment of Benign Prostatic Hyperplasia[J].Medical Information,2022,35(01):109.[doi:10.3969/j.issn.1006-1959.2022.03.026]
[9]孙鹏飞,王华东.前列疏通汤联合非那雄胺治疗良性前列腺增生的临床疗效及对前列腺特异性抗原的影响[J].医学信息,2023,36(14):133.[doi:10.3969/j.issn.1006-1959.2023.14.027]
　SUN Peng-fei,WANG Hua-dong.Clinical Effect of Qianlie Shutong Decoction Combined with Finasteride in the Treatment of Benign Prostatic Hyperplasia and its Effect on Prostate Specific Antigen[J].Medical Information,2023,36(01):133.[doi:10.3969/j.issn.1006-1959.2023.14.027]
[10]张红生,吴景夫,邓小林,等.经尿道等离子前列腺剜除术对患者血流动力学及血生化指标的影响[J].医学信息,2020,33(05):102.[doi:10.3969/j.issn.1006-1959.2020.05.031]
　ZHANG Hong-sheng,WU Jing-fu,DENG Xiao-lin,et al.Effects of Transurethral Plasma Prostatectomy on Hemodynamics and Blood Biochemical Parameters of Patients[J].Medical Information,2020,33(01):102.[doi:10.3969/j.issn.1006-1959.2020.05.031]

更新日期/Last Update: 2020-01-01