摘要
目的比较经尿道保留尿道前壁前列腺剜除术（transurethral ventral preserving enucleation of the prostate,TUVPEP）与经尿道前列腺电切术（transurethral resection of the prostate,TURP）治疗良性前列腺增生患者的安全性、效果和严重并发症。方法200例良性前列腺增生（benign prostatic hyperplasia,BPH）患者,按照前列腺体积大小分为两层,M层为中大前列腺（45-80 g）,L层为巨大前列腺（〉80 g）,每层按随机数字表分为2组。M1组和L1组为试验组,M2组和L2组为对照组。试验组采用作者专利器械＂张氏多功能前列腺手术镜＂进行TUVPEP,简称张氏前列腺剜除术（Zhang’s enucleation of the prostate,ZSEP）,对照组进行TURP,统计手术持续时间、术中出血量、术后住院时间。出院后6个月随访,比较两组国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Q_（max））及严重并发症。采用SPSS 18.0统计软件进行分析,其中连续变量采用x±s表示,两组间比较采用t检验。结果 179例得到随访,试验组出血量显著少于对照组[M1组（27.63±20.35）m L与M2组（31.82±17.35）m L,P〈0.05;L1组（58.35±49.79）m L与L2组（73.39±43.78）m L,P〈0.05]。试验组住院时间显著缩短[M1组（3.80±1.03）d与M2组（6.61±1.91）d,P〈0.01;L1组（4.06±1.29）d与L2组（5.94±1.84）d,P〈0.01]。试验组术后Q_（max）显著高于对照组[M1组（21.10±7.56）m L/s与M2组（16.10±5.94）m L/s,P〈0.01;L1组（25.70±9.18）m L/s与L2组（16.20±5.01）m L/s,P〈0.01];试验组与对照组严重并发症分别为10%与21%,再次手术率分别为0%与6%,差异有统计学意义（P〈0.05）。结论与TURP比较,ZSEP显著减少出血量和手术时间,提高尿流率和减少严重并发症的发生,再次手术率极低,可缩短留置导尿时间和住院时间。
Objective To compare the safety,efficacy and incidence of severe complications of transurethral ventral preserving enucleation of the prostate（ TUVPEP） with transurethral resection of the prostate（ TURP）. Methods Two hundred patients with benign prostatic hyperplasia（ BPH） admitted in our institute from April 2010 to April 2015 were prospectively recruited in this study. According to the size of the prostate,they were divided into M（ the prostate in weight of 45 - 80 g） and L（〉80 g） groups. Every group was further randomly divided into 2 subgroups to respectively undergoing TUVPEP（ M1 and L1） or TURP（ M2 and L2）. Our patent Zhang＇s multifunctional resectoscope was employed in TUVPEP（ also named as Zhang＇s enucleation of the prostate）. The operative time,intra-operative bleeding volume,and post-operative hospital stay were recorded. International prostate sympathetic score（ IPSS）,score of quality of life（ QOL）,maximum flow rate（ Q_（max））,urethral functional length（ UFL）,urethral functional area（ UFA） and incidences of severe complications were investigated in 6 month after operation,and the results were compared between the 2 operative approaches. Results A total of 179 patients completed the 6-month postoperative follow-up.Blood loss was lesser in those receiving TUVPEP than TURP during the operation（ M： 27. 63 ± 20. 35 vs31. 82 ± 17. 35 m L,P〈0. 05; L： 58. 35 ± 49. 79 vs 73. 39 ± 43. 78 m L,P〈0. 05）,and the durations of postoperative hospitalization was also short in the first approach than the latter（ M： 3. 80 ± 1. 03 d vs 6. 61 ±1. 91 d,P〈0. 01; L： 4. 06 ± 1. 29 d vs 5. 94 ± 1. 84 d,P〈0. 001）. Postoperative Q_（max）was obviously high in the former than the latter（ M： 21. 10 ± 7. 56 vs 16. 10 ± 5. 94 m L/s,P〈0. 01; L： 25. 70 ± 9. 18 vs 16. 20 ±5. 01 m L/s,P〈0. 01）. The incidences of severe complications were lower in the former than the latter approaches（ 10% vs 21%）,and so was the re-operative rate（ 0% vs 6%）. Conclusion Compared to TURP,our Zhang＇s enucleation of the prostate has significantly smaller blood loss and shorter operation time,obviously improves Q_（max）and reduces the incidence of severe complications,decreases the re-operative rate,and shortens the times of indwelling catheter and hospital stay.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第3期297-301,共5页
Journal of Third Military Medical University
关键词
前列腺增生
保留尿道前壁
前列腺剜除术
经尿道前列腺电切术
prostate
hyperplasia
preserving ventral urethral wall
enucleation of the prostate
transurethral resection of the prostate
