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目的:探讨大体积BPH患者行经尿道等离子前列腺剜除术(TPKEP)的疗效及对尿道功能与性功能的影响。方法:选取2014年10月~2015年10月收入我院的124例大体积BPH患者,根据随机数字表法分为对照组和观察组,各62例。对照组应用TURP治疗,观察组应用TPKEP治疗。比较两组患者手术相关指标,随访6个月,比较两组患者术前及术后的尿道功能、性功能以及并发症的发生情况。结果:观察组患者手术时间、术中出血量、膀胱冲洗时间、留置导尿时间、血红蛋白降低指数、术后住院时间均少于对照组,而前列腺切除重量多于对照组(P<0.05)。术后,观察组IPSS评分、剩余尿量(RUV)明显低于对照组,最大尿流率(Qmax)明显高于对照组(P<0.05)。术后,两组勃起功能障碍率、逆行射精率均有所上升,但观察组的勃起功能障碍率、逆行射精率均显著低于对照组(P<0.05)。观察组术后继发出血、泌尿系统感染、尿道狭窄发生率均显著低于对照组(P<0.05)。结论:大体积BPH患者行TPKEP术的疗效优于TURP,具有出血少、恢复快、住院时间短、安全性高等优点,可改善尿道功能,降低性功能受损程度,值得在临床上推广应用。
Objective: To investigate the curative effect of transurethral plasmaphotonotomy (TPKEP) and its effect on urethral function and sexual function in large volume BPH patients. Methods: A total of 124 patients with massive BPH admitted to our hospital from October 2014 to October 2015 were divided into control group and observation group according to the random number table method, each of 62 patients. The control group was treated with TURP, and the observation group was treated with TPKEP. The operation-related indexes of the two groups were compared and followed up for 6 months. The preoperative and postoperative urethral function, sexual function and complication were compared between the two groups. Results: The operation time, intraoperative blood loss, bladder irrigation time, indwelling catheterization time, hemoglobin decrease index and postoperative hospital stay in the observation group were all less than those in the control group, while the weight of prostatectomy was more than that of the control group (P <0.05). After operation, the IPSS score and residual urine volume (RUV) of the observation group were significantly lower than those of the control group, and the maximum flow rate (Qmax) was significantly higher than that of the control group (P <0.05). Postoperative erectile dysfunction rate and retrograde ejaculation rate increased in both groups, but erectile dysfunction rate and retrograde ejaculation rate in the observation group were significantly lower than those in the control group (P <0.05). Postoperative secondary hemorrhage, urinary tract infection and urethral stricture in the observation group were significantly lower than those in the control group (P <0.05). CONCLUSION: TPKEP is superior to TURP in treating large-volume BPH patients. It has the advantages of less bleeding, faster recovery, shorter hospital stay and higher safety. It can improve the urethral function and reduce the damage of sexual function, which is worth popularizing in clinic.