摘要目的 比较经尿道等离子双极电切术(PKRP)与经尿道单极电切术(TURP)治疗老年、高危、大体积前列腺增生患者的疗效.方法 对36例老年、高危、大体积前列腺增生患者,分别采取PKRP16例,TURP20例,比较两组的手术时间、术中出血量、切除的前列腺标本重量、术后冲洗时间、拔尿管时间、术后6个月国际前列腺症状(IPSS)评分和最大尿流率.结果 PKRP组和TURP组比较,手术时间分别为(62±23)min和(68±35)min,切除的前列腺标本重量分别为(52±15)g和(56±18)g,术后冲洗时间分别为(16±12)h和(18±10)h,拔管时间分别为(5±2)d和(6±1)d,术后IPSS评分分别为(6.8±3.4)和(7.4±4.2)分,最大尿流率分别为(15.8±6.2)ml/s和(15.2±5.3)ml/s,组间比较,差异无统计学意义;术中出血量,PKRP组为(283±155)ml,少于TURP组的(465±264)ml(P<0.05);且PKRP组无术中输血,TURP组有1例(P<0.01);两组术后6个月IPSS评分、最大尿流率均较术前显著改善,PKRP组IPSS分别为(27.8±3.5)和(6.8±3.4)分,最大尿流率分别为(4.5±2.7)ml/s和(15.8±6.2)ml/s;TURP组IPSS分别为(29.2±6.1)和(7.4±4.2)分,最大尿流率分别为(5.2±3.6)ml/s和(15.2±5.3)ml/s,组内差异有统计学意义(P<0.01).结论 PKRP与TURP有相似的电切效率和手术效果,但PKRP出血较少,对高危、大体积前列腺患者更安全.

abstractsObjective To compare the efficacy and safety of transurethral plasmakinetic resection of the prostate(TUPKRP)and transurethral resection of prostate(TURP). Methods A total of 36 elderly patients with large volume prostate and high-risk benign prostatic hypertrophy were involved in this study.Among them,16 patients underwent PKRP and 20 patients underwent TURP.The operation time,blood loss,resected prostate weight,continuous bladder irrigation time,catheterization time,international prostate symptom score(IPSS)and Omax 6 months post-operation were compared between PKRP group and TURP group. Results There was no significant difference in all parameters except the blood losss between the 2 groups.The blood loss was less in TUPKRP group than in TURP group[(283±155)ml vs.(465±264)ml,P<0.05],and no blood transfusion needed during operation in TUPKRP group(O case vs.2 cases,P<0.01).However,IPSS and Omax 6 months post-operation improved significantly as compared with preoperation in the 2 groups(PKRP:(27.8±3.5)vs.(6.8±3.4),(4.5±2.7)ml/s us.(15.8±6.2)ml/s;TURP:(29.2±6.1)vs.(7.4±4.2),(5.2±3.6)ml/s vs.(15.2±5.3)ml/s,all P<0.01). Conclusions The effect of TUPKR is similar to TURP,but TUPKR is more safety than TURP for the elderly patients with large volume and high-risk BPH.