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目的:探讨经尿道前列腺切除术中前列腺尖部腺体的切除方法,分析比较对前列腺尖部腺体采用逆行剜除法与顺行切除法两种方法的疗效差异。方法:2010年1月～2011年3月间对82例BPH患者采用经尿道等离子双极电切术(TUPKP),按对尖部腺体切除方法的不同,随机分为尖部腺体逆行剜除组(观察组)和顺行切除组(对照组)治疗。并随访6～12个月,平均7.8个月。结果:全组82例手术均获得成功,无中转开放手术及大出血等严重并发症。77例获得6个月以上的随访,其中观察组40例,对照组37例,5例失访。两组在年龄组成、病程、术前前列腺质量(W)、剩余尿量(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)方面的差异无统计学意义(P>0.05);两组在手术时间、切除组织量及术后住院时间方面差异无统计学意义(P>0.05);术后6个月,两组在IPSS、QOL、RUV及Qmax方面比较,观察组优于对照组,差异有统计学意义(P<0.05)。结论:在经尿道前列腺切除术中,采用尖部腺体逆行剜除法较顺行切除法有更好的近期治疗效果。
Objective: To explore the method of resection of prostatic gland in transurethral resection of prostate and analyze the difference of curative effect between retrograde resection and retrograde resection on prostatic gland. Methods: From January 2010 to March 2011, 82 patients with BPH were treated with transurethral plasma bipolar (TUPKP). According to the different methods of apical gland resection, they were randomly divided into retrogynaptic In addition to the group (observation group) and cis-resection group (control group) treatment. And followed up for 6 to 12 months, an average of 7.8 months. Results: All the 82 cases were successful in operation. There were no serious complications such as open surgery and bleeding. 77 cases were followed up for more than 6 months, of which 40 cases in the observation group, 37 cases in the control group and 5 cases were lost. No significant differences were found in age, course of disease, preoperative prostate mass (W), residual urine volume (RUV), IPSS, QOL, Qmax (P> 0.05). There was no significant difference in the operation time, the amount of resected tissue and the length of postoperative hospital stay between the two groups (P> 0.05). At 6 months after operation, the IPSS, QOL, RUV and Qmax In comparison, the observation group was better than the control group, the difference was statistically significant (P <0.05). CONCLUSIONS: In transurethral resection of the prostate, retrograde appendectomy with apical glands has a better short-term therapeutic effect than paralectomic excision.