彭友彬

【摘要】 目的：探析大體积前列腺增生予以传统经尿道前列腺电切术（TURP）和经尿道前列腺剜除电切术治疗的临床效果。方法：临床选择2017年5月-2018年3月在笔者所在医院就诊的大体积前列腺增生患者90例，根据随机对照法分为研究组（n=46）与对照组（n=44），研究组予以经尿道前列腺剜除电切术，对照组予以传统经尿道前列腺电切术（TURP）治疗。比较两组尿管留置时间、冲洗膀胱时间、术中出血量、前列腺切除量、住院时间等指标变化;治疗后1个月比较两组术后国际前列腺症状评分（IPSS）、残留尿量、最大尿流率等指标变化;比较两组术后并发症。结果：研究组尿管留置时间、冲洗膀胱时间、术中出血量、住院时间均低于对照组，前列腺切除量高于对照组，差异均有统计学意义（P<0.05）;研究组术后1个月IPSS评分、残留尿量均低于对照组，最大尿流率高于对照组，差异均有统计学意义（P<0.05）;研究组排尿困难、膀胱痉挛、尿失禁等并发症总发生率低于对照组，差异有统计学意义（P<0.05）。结论：大体积前列腺增生经尿道前列腺剜除术治疗，术中出血量低，缩短住院时间、尿管留置时间、冲洗膀胱时间，显著改善临床症状，术后并发症少。

【关键词】 大体积前列腺增生 并发症 TURP 等离子前列腺剜除术

doi：10.14033/j.cnki.cfmr.2019.29.019 文献标识码 B 文章编号 1674-6805（2019）29-00-03

[Abstract] Objective： To discuss the clinical effect of conventional transurethral resection of the prostate （TURP） and transurethral enucleation of the prostate in large-volume benign prostatic hyperplasia （BPH）. Method： A total of 90 large-volume BPH patients treated from May 2017 to March 2018 in our hospital were selected and randomly assigned to research group （n=46） and control group （n=44）. The research group was treated with transurethral enucleation of the prostate， the control group was treated with TURP. The catheter indwelling time， flushing time， intraoperative blood loss， resection volume and hospitalization time were compared， after 1 month of treatment， IPSS （international prostate symptom score）， residual urinary volume， maximum flow rate were compared. Result： The indwelling time of catheter， the time of flushing bladder， the amount of intraoperative bleeding and the time of hospitalization in the study group were lower than those in the control group， and the amount of prostatectomy in the study group was significantly higher than that in the control group， the differences were statistically significant （P<0.05）. The scores of IPSS and residual urine in the study group were lower than those of the control group， and the maximum urinary flow rate was higher than that of the control group， the differences were statistically significant （P<0.05）. The total incidence rate of complications like dysuria， bladder spasm and urinary incontinence in the research group was lower than control group， the difference was statistically significant （P<0.05）. Conclusion： In the treatment of large volume of prostatic hyperplasia， the amount of blood loss in the operation of the transurethral resection of the prostate is reduced， the hospital stay time is shortened， the indwelling time is prolonged， the time of the bladder is washed， the clinical symptoms are obviously improved， and the postoperative complications are less.

[Key words] Large-volume benign prostatic hyperplasia Complication TURP Plasmakinetic enucleation of the prostate

First-authors address： The Second Affiliated Hospital of Shantou University Medical College， Shantou 515041， China

前列腺增生（BPH）是导致中老年男性排尿障碍因素中的最常见的良性疾病之一。男性在35岁开始出现不同程度的前列腺增生，约有半数51～60岁男性出现前列腺增生[1]。如不能有效及时诊治可导致输尿管结石、尿失禁、尿潴留等后遗症，患者的生活质量严重下降。大体积前列腺增生临床主要进行手术治疗，但外科手术种类较多，对术式的选择及临床效果评估存在一定的争议。近年来隨着等离子电切术的发展，予以前列腺等离子剜除术可显著降低术后并发症，促进患者迅速康复[2]。本研究临床选择2017年5月-2018年3月在笔者所在医院接受治疗的大体积前列腺增生患者予以传统TURP术及等离子前列腺剜除电切术治疗，比较两种术式的临床效果，现报道如下。……