摘要目的 对比观察经尿道前列腺电切术(TURP)与经膀胱前列腺摘除术(SPPC)治疗高龄前列腺增生患者的临床效果.方法 将70例高龄前列腺增生患者分为TURP组与SPPC组各35例,TURP组采用经尿道前列腺电切术治疗,SPPC组采用经膀胱前列腺摘除术治疗.结果 两组患者的围术期指标仅有切除前列腺重量这项指标组间比较不具有统计学意义(P＞0.05),而手术时间、术中出血量、膀胱冲洗时间、导尿管留置时间以及住院时间等5项指标数据均以TURP组显著小于SPPC组(P＜0.01);术后两组患者的IPSS、QOL及PVR等3项指标均较术前显著降低(P＜0.05),MFR均较术前显著升高(P＜0.05),而术后3个月与术后12个月的组间同期比较结果均显示,TURP组IPSS、QOL、PVR等3项的降低程度均显著大于SPPC组(P＜0.01),而MFR的升高程度也均显著大于SPPC组(P＜0.05);SPPC组所有患者均未输血,TURP组输血2例,SPPC组全部患者均有发生膀胱痉挛并3例切口感染,TURP组仅2例膀胱痉挛且未有切口感染病例,另外TURP组有少数患者出现电切综合征、术后尿道口狭窄、术后暂时性尿失禁以及尿外渗等并发症,而SPPC组未见此4类并发症.结论 在条件皆比较完善的情况下,选择TURP治疗高龄前列腺增生患者其安全性及疗效也是有足够保障的,具进一步在临床推广的价值.

abstractsObjectives To compare the clinical effect of transurethral resection of prostate (TURP) and suprapublic transvesical prostatectomy (SPPC) clinical in the treatment of elderly patients with hyperplasia of prostate.Methods 70 cases of senile patients with benign prostatic hyperplasia(BPH) were divided into TURP group(n =35) and SPPC group(n =35).Results There was not statistical significance in excision prostate weight of perioperative indicators between the two groups(P ＞ 0.05),and the operation time,intraoperative blood loss,bladder douche time,catheter indwelling time and hospital stay in TURP group were significantly less than the SPPC group(P ＜ 0.01).Two groups of patients with Compared with preoperative values,postoperative IPSS,QOL and PVR significantly reduced (P ＜0.05),the MFR was significantly higher than before operation (P ＜0.05).IPSS,QOL and PVR in TURP group were significantly lower than SPPC group after 3 months and 12 monthsP ＜0.01).Blood transfusion in the SPPC group was not performed,2 cases of blood transfusion in the TURP group were performed.Bladder spasm in SPPC group happened and 3 cases of incision infection and bladder spasm occured in SPPC group,only 2 cases of bladder spasm happened in TURP group and without incision infection,a few patients with cutting syndrome,postoperative urethral stricture,postoperative complications such as temporary incontinence and urinary extravasation occured in TURP group.Conclusions When medical environment is perfect,TURP and SPPC in the treatment of elderly patients with BPH is safety,efficacy and security,and worth clinical promotion.