贾其磊　郑泽贵　杜龙　刘文兵　邓家富　汪海波

【摘要】 目的：探讨改良前列腺等离子电切术治疗老年前列腺增生的效果和安全性。方法：2014年5月-2016年2月对122例前列腺增生症患者实施经尿道前列腺等离子电切术，随机分为两组，对照组47例行常规前列腺等离子电切术，治疗组75例行改良前列腺等离子电切术。分别对手术前、手术后1周及1个月IPSS评分、QOS评分、Qmax、并发症发生等进行分析。结果：对照组及治疗组术前及术后IPSS评分、QOS评分、Qmax等指标比较差异有统计学意义（P<0.05）；术后1周和1个月比较，差异无统计学意义（P>0.05）。所有患者拔管后均能顺利排尿，术后1周对照组35例（74.47%）、治疗组53例（70.67%）诉尿急；术后1个月随访，对照组19例（40.43%）、治疗组25例（33.33%）患者诉尿急症状，差异有统计学意義（P<0.05）。结论：改良经尿道前列腺等离子电切术可提高手术的安全性，改善患者生活质量，减少并发症，更使患者获益。

【关键词】 前列腺增生； 改良前列腺等离子电切术； 效果

doi：10.14033/j.cnki.cfmr.2017.30.010 文献标识码 B 文章编号 1674-6805（2017）30-0020-03

The Clinical Study of Modified Transurethral Plasmakinetic Resection of Prostate/JIA Qi-lei，ZHENG Ze-gui，DU Long，et al.//Chinese and Foreign Medical Research，2017，15（30）：20-22

【Abstract】 Objective：To investigate the efficacy and safety of transurethral resection of prostate for the treatment of benign prostatic hyperplasia.Method：From May 2014 to February 2016，122 cases of benign prostatic hyperplasia were randomly divided into 2 groups，all the patients implemented transurethral resection of prostate（TURP）.In the control group，47 cases were implementation of the conventional TURP.In the treatment group，75 patients were treated with modified TURP.IPSS，QOS，Qmax，and other complications before surgery and 1 week and 1 month after surgery were compared respectively.Result：The differences of preoperative and postoperative IPSS score，QOS score，Qmax of the control group and the treatment group were statistically significant（P<0.05）.The IPSS score，QOS score and Qmax score were not statistically significant between the two groups after 1 week and 1 month（P>0.05）.All patients were able to urinate after extubation.35 cases（74.47%） in the control group and 53 cases（70.67%） in the treatment group in postoperative 1 week had the symptoms of urgency.19 cases（40.43%） in the control group and the 33 cases（33.33%） in the treatment group at 1 month after surgery had urgency symptoms，the difference was statistically significant（P<0.05）.Conclusion：The improved surgical method can improve the safety of operation，improve the quality of life of patients，reduce complications and benefit patients.

【Key words】 Benign prostatic hyperplasia； Modified transurethral plasmakinetic resection of prostate； Effect

First-authors address：The Peoples Hospital of Qingbaijiang District of Chengdu，Chengdu 610300，China

经尿道前列腺电切术（Transurethral resection of the prostate，TURP）是临床上治疗老年男性良性前列腺增生症（Benign prostatic hyperplasis，BPH）的“金标准”。为了提高前列腺等离子电切术的疗效及安全性，现将笔者所在医院2014年5月-2016年endprint

2月122例实施TURP术的患者进行了对照研究，报道如下。

1 资料与方法

1.1 一般资料

本组共122例，年龄54～96岁，平均75岁，病程16个月～15年，平均2.5年。主诉症状：进行性排尿困难45例，急性尿潴留67例，反复血尿8例，反复尿路感染2例。所有病例均行B超检查测其前列腺平均体积（47.0±15.5）ml和膀胱残余尿（50.0±42.5）ml。术前前列腺症状评分（IPSS）为（25.5±1.5）分，生活质量评分（QOS）为（5.2±0.3）分，直肠指诊和血清前列腺特异性抗原（PSA）检查排除前列腺癌，合并高血压82例，合并糖尿病35例，有脑梗塞病史8例，肾积水、肾功能不全5例，合并膀胱结石者12例。……