目的：对经尿道前列腺电切术（TURP）和 TURP 联合经尿道膀胱颈切开术（TUIBN）治疗小体积前列腺增生的临床疗效进行比较分析。方法选取具有完整随访资料的108例小体积前列腺增生患者作为研究对象，其中采用TURP 治疗的48例患者为 TURP 组，采用 TURP 联合 TUIBN 治疗的60例患者为 TURP + TUIBN 组。对两组患者手术前后国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（MFR）、残余尿（PVR）、组织切除质量、随访时间以及膀胱颈挛缩的发生率进行检测和评价，并对结果进行比较分析。结果与 TURP 组患者相比，TURP + TUIBN 组患者MFR 明显增高，PVR、IPSS 以及 QOL 则明显降低（ P ﹤0.05），术后两组患者在组织切除质量以及随访时间方面均无明显差异（ P ﹥0.05）。TURP + TUIBN 组的膀胱颈挛缩的发生率（3.3%）明显低于 TURP 组（14.6%），差异具有统计学意义（ P ﹤0.05）。结论 TURP 与 TUIBN 联合治疗小体积前列腺增生相比单纯 TURP 治疗更能有效改善患者的临床症状，降低术后膀胱颈挛缩的发生率，提高治疗效果，因此可作为治疗小体积前列腺增生的首选手术方案。%Objective To compare and analyze the clinical effect of TURP with TUIBN for the treatment of small hyperplasia of prostate. Methods 108 patients with small volume of hyperplasia of prostate were included into this study and as the research objects. 48 patients were treated with TURP and considered as the TURP group. The other 60 patients who were treated with TURP combined TUIBN was considered as the TURP + TUIBN group. The international prostate symptom score(IPSS),quality of life score(QOL),maximum urinary flow rate(MFR),resid-ual urine(PVR),quality of tissue resection,follow - up time,and incidence of bladder neck contracture of patients in two groups before and after surgery were tested,evaluated and compared. Results The comparison of the patients in the TURP group and the TURP + TUIBN group showed that the MFR of the TURP + TUIBN group was significantly higher. The PVR,IPSS,QOL were significantly reduced. The quality of tissue resec-tion and postoperative follow - up time of patients in two groups had no obvious difference( P ﹥ 0. 05). While in terms of the incidence of bladder neck contracture,the TURP group and TURP + TUIBN group were 14. 6% and 3. 3% respectively. The differences were obvious( P ﹤ 0. 05)with statistically significant. Conclusion The combination therapy of TURP and TUIBN in treatment for small volume of hyperplasia comparing with pure TURP treatment can effectively improve the patient′s clinical symptoms,reduce the incidence of postoperative bladder neck contracture,and improve the treatment effect. This method can be used as a preferred treatment for small volume hyperplasia of prostate surgery.
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