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目的分析经尿道前列腺等离子腔内剜除术(PKEP)治疗大体积(>80 ml)良性前列腺增生(BPH)的临床疗效。方法回顾性分析2009年3月至2013年2月128例行PKEP或经尿道前列腺双极电切术(TUPKP)治疗的大体积BPH患者的临床资料,并于术后第1、3、6个月进行随访。结果 PKEP组(72例)和TUPKP组(56例)患者年龄、病程、前列腺体积差异无统计学意义(P>0.05);手术时间分别为(93.7±27.5)min和(89.8±22.4)min,差异无统计学意义(P>0.05)。前列腺切除质量和比例分别为(64.2±22.1)g和(52.7±28.6)g、(64.17±10.15)%和(54.45±9.62)%,术后膀胱冲洗和导尿管留置时间、住院天数分别为(20.7±6.5)h和(29.6±8.3)h、(4.3±1.5)d和(5.6±2.1)d、(5.2±1.4)d和(6.5±1.9)d,各有并发症3例和9例,各项指标组间比较差异均有统计学意义(P<0.05);2组患者术前及术后第3个月随访时残余尿量(RUV)、最大尿流率(Qmax)、国际前列腺症状评分(I-PSS)、生活质量指数(QOL)评分组间比较,差异均无统计学意义(P>0.05),但各指标均较术前明显改善(P<0.05)。结论 PKEP术治疗大体积BPH的近期疗效、手术时间与TUPKP术相似;但其有效性、彻底性和安全性优于TUPKP术。
Objective To analyze the clinical effect of transurethral resection of plasmapheresis (PKEP) for treatment of large volume (> 80 ml) benign prostatic hyperplasia (BPH). Methods The clinical data of 128 patients with large volume BPH treated with PKEP or TUPKP between March 2009 and February 2013 were retrospectively analyzed. Month follow-up. Results There were no significant differences in age, course of disease and prostate volume between PKEP group (72 cases) and TUPKP group (56 cases) (P> 0.05). The operative time was (93.7 ± 27.5) min and (89.8 ± 22.4) min, The difference was not statistically significant (P> 0.05). The mass and proportion of prostatectomy were (64.2 ± 22.1) g and (52.7 ± 28.6) g, (64.17 ± 10.15)% and (54.45 ± 9.62)% respectively. The postoperative bladder irrigation and urinary catheter indwelling time and hospital stay were (20.7 ± 6.5) h and (29.6 ± 8.3) h, (4.3 ± 1.5) days and (5.6 ± 2.1) days, (5.2 ± 1.4) days and (P <0.05). The residual urine volume (RUV), maximum flow rate (Qmax) at the third month after operation in both groups were significantly lower than those in the control group Prostate symptom score (I-PSS) and quality of life index (QOL) were not significantly different between the two groups (P> 0.05), but all indexes were significantly improved compared with that before operation (P <0.05). Conclusions PKEP is effective in treating short-term BPH. The operation time is similar to that of TUPKP. However, its efficacy, thoroughness and safety are better than TUPKP.