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前列腺剜切术、电切术、剜除术治疗前列腺增生的疗效对比研究
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Abstract:
目的：对比观察经尿道前列腺剜切术(TUERP)、电切术(TURP)、剜除术(TUEP)治疗前列腺增生症的效果。方法：将2020年3月至2021年4月青岛大学附属医院收治的120例前列腺增生患者作为研究对象进行回顾性分析，依据手术方法的不同分为TUERP组、TURP组、TUEP组，每组均为30例，收集三组术前、术中、以及术后随访数据进行分析。结果：三组手术均顺利完成，无中途转为开放手术的病例。术后三组患者在最大尿流率(Maximum flow rate, Qmax) (18.8 ± 4.7, 18.9 ± 4.8, 18.2 ± 4.6)、残余尿量(Postvoid residua, PVR) (6.8 ± 12.9, 4.8 ± 9.9, 6.3 ± 12.5)、生活质量(Quality of life score, QOL) (2.7 ± 1.8, 2.4 ± 1.7, 2.3 ± 1.6)和国际前列腺症状评分(International prostate symptom score, IPSS)(8.2 ± 3.9, 8.6 ± 3.7, 8.3 ± 4.2)四项指标中均有明显改善，无统计学差异(P > 0.05)。经尿道前列腺剜切术的手术时间、血红蛋白手术前后变化分别为(65.8 ± 24.4) min、(15.6 ± 11.5) g/L，优于经尿道前列腺电切术，差异具有统计学意义(P < 0.05)，术后尿失禁、逆向射精的发生率分别为0%、22.5%，低于经尿道前列腺剜除术，差异具有统计学意义(P < 0.05)。结论：与经尿道前列腺电切术和剜除术相比，经尿道等离子前列腺剜切手术简单，安全有效，术后并发症较少，是年轻住院医师可以较快掌握的一种手术方式。
Objective: To compare the effects of transurethral enucleation and resection of the prostate (TUERP), transurethral resection of the prostate (TURP) and transurethral enucleation of the pros-tate (TUEP) in the treatment of prostatic hyperplasia. Methods: The clinical data of 120 patients with BPH treated in Affiliated Hospital of Qingdao University from March, 2020 to April, 2021 were retrospectively analyzed. They were divided into TUERP group, TURP group and TUEP group ac-cording to different surgical methods. There were 30 cases in each group. The preoperative, peri-operative and postoperative follow-up data of three groups were compared. Results: All the three groups were successfully completed, and no cases were converted to open surgery midway. Maxi-mum urine flow rate (18.8 ± 4.7, 18.9 ± 4.8, 18.2 ± 4.6), residual urine volume (6.8 ± 12.9, 4.8 ± 9.9, 6.3 ± 12.5), QOL (2.7 ± 1.8, 2.4 ± 1.7, 2.3 ± 1.6) and IPSS (8.2 ± 3.9, 8.6 ± 3.7, 8.3 ± 4.2) were signifi-cantly improved among the three groups after surgery, with no statistical difference (P > 0.05). The operative time and hemoglobin before and after TUERP were (65.8 ± 24.4) min and (15.6 ± 11.5) g/L, respectively, which were better than TURP, and the difference was statistically significant (P < 0.05). The incidences of urinary incontinence and reverse ejaculation were 0% and 22.50%, re-spectively, which were significantly lower than those of TUEP, the difference was statistically signif-icant (P < 0.05). Conclusion: Compared with TURP and TUEP, TUERP is a simple, safe and effective operation with few postoperative complications. It is a kind of operation method that novices can master quickly.
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