目的 比较分析尿道前列腺切除术(TURP)和经尿道前列腺离子剜除术(TPKEP)对良性前列腺增生(BPH)的治疗效果,并研究其对围手术期指标以及最大尿流率(Qmax)、残余尿量(PVR)、血清前列腺特异抗原(PSA)等指标的影响.方法 选取2014年3月—2016年3月武汉科技大学附属天佑医院胃肠泌尿外科收治的128例BPH患者为研究对象,按随机数字表法分为对照组和观察组,各64例,其中对照组采用TURP进行治疗,观察组采用TP-KEP治疗,治疗3个月后比较2组患者的围手术期指标,记录Qmax、QVR和PSA水平,并对患者的前列腺症状评分(IPSS)以及生活质量评分(QOL)进行比较,期间观察患者不良反应发生情况.结果 手术过程中,观察组患者手术出血量和手术时间明显少于对照组(t=11.269、21.164,P<0.01),术后导管滞留时间也短于对照组(t=7.048,P<0.05);术后2组患者的IPSS评分以及QOL评分明显改善(t对照组=40.377、7.633,t观察组=44.704、10.563,P<0.05),且观察组患者的值优于对照组(t=8.759、4.854,P<0.05);术后2组患者的Qmax、PVR和PSA指标明显改善,其中Qmax显著升高,PVR和PSA下降(P<0.05),且观察组患者改善优于对照组(t=8.543、17.346、7.876,P<0.05);术后2组患者均发生排尿困难和假性尿失禁现象,其中对照组患者分别为10例(15.6%)和15例(23.4%),观察组分别为2例(3.12%)和5例(7.81%),2组比较差异具有统计学意义(χ2=5.89、5.93,P<0.05),所有不良反应均在治疗3个月后消失.结论 与TURP相比,采用TPKEP治疗前列腺增生,患者疗效好、恢复快、安全性高、不良反应少,值得进一步研究以拓宽在临床上的应用情况.%Objective To compare and analyze the treatment effects of transurethral resection of prostate ( TURP) and transurethral plasma kinetic enucleation of the prostate ( TPKEP) on benign prostatic hyperplasia ( BPH) ,and the influ-ence on operation indexes,maximum urinary flow rate (Q max),post-void residual volume (PVR),prostate specific antigen ( PSA) indicators. Methods One hundred and twenty-eight cases of patients in Tianyou hospital affiliated to Wuhan Univer-sity of Science and Technology were chosen as the research objects, they treated in our hospital from March 2014 to March 2016 and randomly divided into control group and observation group,each group with 64 cases. The control group used TURP treatment, while the observation group adapted with TPKEP. 3 months after treatment, compare the curative effects of two groups of patients, measure the level of Q max, PVR and PSA levels. Evaluate prostate symptoms and quality of life of pa-tients and observe the patients' side effects during the treatment. Results The operation time of the patients in the observa-tion group was significantly less than the control group (t=11. 269, t=21. 164, P< 0. 05),and the postoperative catheter retention was also shorter than the control group (t=7. 048, P< 0. 05). In addition, the IPSS scores and quality of life scores of the two groups were significantly improved (P< 0. 05), and the scores of patients in the observation group were bet-ter (P< 0. 05). Two groups of patients with postoperative Q max, PVR and PSA index improved significantly after surgery, with significantly increased Q max, PVR and PSA declined (P< 0. 05). And indexes of observation group of patients im-proved more significantly than the control group (t=8. 543, t=17. 346, t=7. 876, P< 0. 05). As for the postoperative dysuria and pseudo urinary incontinence, the control group had 10 patients (15. 6%) and 15 patients (23. 4%) respectively, while the observation group were 2 patients (3. 12%) and 5 patients (7. 81%) respectively. The results showed statistically different (χ2 =5. 89,χ2 =5. 93,P< 0. 05), and all adverse reactions disappeared after treatment 3 months. Conclusion Compared with TURP, the TPKEP is used to treat prostate hyperplasia, and patients with good curative effect, quick recovery and low adverse reaction of safety. It is worth further study to broaden the clinical application.
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