黄沛东 卢勇 陈晓生

【摘要】 目的：探討经尿道双极等离子前列腺剜除术治疗老年前列腺增生的临床应用效果。

方法：选取2017年1月-2018年6月本院收治的84例前列腺增生患者。按照随机数字表法将其分为研究组和对照组，各42例。对照组予以经尿道双极等离子前列腺电切术治疗，研究组予以经尿道双极等离子前列腺剜除术治疗。比较两组手术时间、术中出血量、切除前列腺质量、术后住院时间、残余尿量（PVR）、最大尿流率（Qmax）、国际前列腺症状评分（IPSS）、性功能以及并发症发生情况。结果：研究组手术时间、术后住院时间均短于对照组，术中出血量少于对照组，切除前列腺质量大于对照组，差异均有统计学意义（P<0.05）;研究组并发症发生率为16.67%，显著低于对照组的35.71%（P<0.05）;术后6个月，研究组PVR、IPSS评分均低于对照组，Qmax高于对照组，差异均有统计学意义（P<0.05）;术后6个月，对照组勃起功能障碍、逆行射精比例均高于术前及研究组，研究组逆行射精比例高于术前，差异均有统计学意义（P<0.05），研究组手术前后勃起功能障碍比例比较，差异无统计学意义（P>0.05）。结论：经尿道双极等离子前列腺剜除术治疗老年前列腺增生效果确切，对患者损伤小，可显著改善患者尿道功能。

【关键词】 前列腺增生; 经尿道双极等离子前列腺剜除术; 尿道功能; 性功能

【Abstract】 Objective：To investigate the clinical effect of transurethral bipolar plasma prostatectomy for elderly patients with benign prostatic hyperplasia.Method：A total of 84 patients with benign prostatic hyperplasia from January 2017 to June 2018 were selected.According to the random number table method，they were divided into study group and control group，42 cases in each group.The control group was treated with transurethral bipolar plasmakinetic resection，while study group was treated with transurethral bipolar plasma prostatectomy.The operation time，intraoperative bleeding volume，quality of resected prostate，hospitalization time，residual urine volume（PVR），maximum urinary flow rate（Qmax），international prostate symptom score（IPSS），sexual function and complications between two groups were compared.Result：The operation time and hospitalization time of study group were shorter than those of control group，the amount of bleeding during operation was less than that of control group，the quality of resected prostate was higher than that of control group，the differences were statistically significant（P<0.05）.The incidence of complications was 16.67% in study group，which was significantly lower than 35.71% of control group（P<0.05）.6 months after operation，the PVR and IPSS scores of study group were lower than those of control group，and Qmax was higher than that of control group，the differences were statistically significant（P<0.05）.6 months after operation，the proportion of erectile dysfunction and retrograde ejaculation in control group were higher than those of before operation and study group，the proportion of retrograde ejaculation in study group was higher than that of before operation，the differences were statistically significant（P<0.05），the proportion of erectile dysfunction before and after operation in study group was compared，the difference was not statistically significant（P>0.05）.Conclusion：Transurethral bipolar plasma prostatectomy of the prostate is effective in treatment of elderly patients with benign prostatic hyperplasia，with less damage，and can significantly improve the urethral function of patients.

【Key words】 Benign prostatic hyperplasia; Transurethral bipolar plasma prostatectomy; Urethral function; Sexual functionFirst-authors address：Jieyang Peoples Hospital，Jieyang 522000，China

doi：10.3969/j.issn.1674-4985.2019.17.013

前列腺增生是一种良性排尿障碍疾病，多见于中老年男性，患者主要临床表现为疼痛、尿液异常、排尿异常、性功能减低等，对患者生活及工作造成严重影响[1]。临床中主要采用手术方式治疗，但手术方式较多。经尿道双极等离子前列腺电切术和经尿道双极等离子前列腺剜除术是临床中常用的手术方式[2-3]。本文旨在探讨经尿道双极等离子前列腺电切术和经尿道双极等离子前列腺剜除术治疗老年前列腺增生患者的临床疗效。现将本院前列腺增生患者使用两种方式治疗的情况进行分析，现报道如下。……