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目的:对比分析经尿道等离子双极电切术(PKRP)治疗大体积(>80 ml)良性前列腺增生(BPH)的疗效与安全性。方法:2009年6月～2011年1月间行PKRP术治疗BPH患者52例,按前列腺体积分为>80 ml组和<80 ml组,每组26例。术后随访3～14个月。结果:>80 ml组国际前列腺症状评分(IPSS)、刺激症状评分(IPSS1)、梗阻症状评分(IPSS2)分别由术前的(19.85±6.534)、(8.73±3.054)、(11.12±4.484)下降至术后的(7.38±4.964)、(4.88±3.421)、(2.50±2.502)(P<0.01)。<80 ml组分别由术前的(21.04±6.453)、(9.00±3.225)、(12.04±4.556)下降至术后的(6.27±3.811)、(4.69±3.185)、(1.58±2.301)(P<0.01)。3项指标术前、术后数值分别进行两组间对比,差异均无统计学意义(P>0.05)。>80 ml组平均手术时间106.15 min,平均切除前列腺质量58.64 g;<80 ml组分别为60.19 min、30.00 g,差异存在统计学意义(P<0.01),余两组术中出血量、术后膀胱冲洗时间,留置尿管时间、术后住院天数差异均无统计学意义(P>0.05)。>80 ml组术中或术后输血患者5例,<80 ml组1例。两组均无经尿道电切综合征(TURS)发生。结论:PKRP术治疗大体积(>80ml)BPH安全、有效,且手术效果和安全性与治疗<80 ml的BPH相似。
Objective: To compare the efficacy and safety of transurethral plasmapapolar excision (PKRP) in the treatment of large volume (> 80 ml) benign prostatic hyperplasia (BPH). Methods: From June 2009 to January 2011, 52 patients with BPH undergoing PKRP were divided into two groups according to the volume of prostate:> 80 ml group and <80 ml group, with 26 cases in each group. The patients were followed up for 3 to 14 months. Results: The scores of IPSS, IPSS1 and IPSS2 in> 80 ml group were decreased from (19.85 ± 6.534), (8.73 ± 3.054) and (11.12 ± 4.484) To (7.38 ± 4.964), (4.88 ± 3.421), (2.50 ± 2.502), respectively (P <0.01). <80 ml group decreased from (21.04 ± 6.453), (9.00 ± 3.225), (12.04 ± 4.556) to (6.27 ± 3.811), (4.69 ± 3.185), (1.58 ± 2.301) <0.01). Three indicators of preoperative and postoperative values were compared between the two groups, the difference was not statistically significant (P> 0.05). > 80 ml group had an average operation time of 106.15 min and an average of 58.64 g of resected prostate mass respectively. The group with <80 ml was 60.19 min and 30.00 g respectively, with significant difference (P <0.01) Bladder flushing time, indwelling catheter time, postoperative hospitalization days were no significant difference (P> 0.05). Five cases of intraoperative or postoperative transfusions were found in> 80 ml group, and one case in <80 ml group. No transurethral resection syndrome (TURS) occurred in either group. Conclusions: PKRP is safe and effective in the treatment of large volume (> 80ml) BPH, and its efficacy and safety are similar to BPH in the treatment of <80 ml.