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目的:比较经尿道前列腺等离子电切术(PKPR)和经膀胱前列腺摘除术(TVP)治疗大体积(100～150ml)良性前列腺增生(BPH)的安全性和有效性。方法:将100例体积介于100～150ml的BPH患者随机分配到PKRP组和TVP组。术前分析相关临床资料,术后1个月、3个月、6个月和12个月对患者进行随访,评估指标包括国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)和膀胱剩余尿量(PVR),并记录不良事件。结果:总计有96例患者完成了12个月的随访,PKRP组手术时间较长,但术中失血量少;TVP组虽然有较高的输血率,但腺体切除率占明显优势。PKRP组术后留置导尿管时间、膀胱冲洗时间及住院时间明显缩短。术后1个月,两组的评估指标均得到显著改善,下尿路症状的改善状态在术后12个月内均维持着稳定状态,两组间IPSS、QOL、Qmax和PVR参数并无明显差异。虽然术后两组的并发症发生率较少,但PKRP组的尿道狭窄发生率高于TVP组。结论:对于体积介于100～150ml的BPH患者,PKRP是一种安全有效的治疗方式,能达到传统开放手术的效果。
Objective: To compare the safety and efficacy of transurethral resection of the prostate (PKPR) and transurethral resection of the prostate (TVP) in the treatment of large-volume (100-150 ml) benign prostatic hyperplasia (BPH). Methods: 100 patients with BPH ranging from 100 ml to 150 ml were randomly assigned to PKRP group and TVP group. The patients were followed up for 1 month, 3 months, 6 months and 12 months after operation. The assessment indexes included International Prostate Symptom Score (IPSS), Quality of Life Score (QOL), Maximum Urine Flow Rate (Qmax) and residual bladder volume (PVR), and record adverse events. Results: A total of 96 patients completed a 12-month follow-up. The operation time in PKRP group was longer but blood loss was less during operation. Although the blood transfusion rate was higher in TVP group, the rate of glandular resection accounted for obvious advantages. PKRP group postoperative indwelling catheter time, bladder irrigation time and hospitalization time was significantly shorter. At 1 month after operation, the evaluation indexes of both groups were significantly improved, and the improvement of lower urinary tract symptoms remained stable within 12 months after operation. There were no significant differences in IPSS, QOL, Qmax and PVR parameters between the two groups difference. Although postoperative complications were less frequent in both groups, the incidence of urethral stricture was higher in the PKRP group than in the TVP group. Conclusion: PKRP is a safe and effective treatment for BPH patients with the volume of 100 ~ 150ml, which can achieve the effect of traditional open surgery.