经尿道等离子前列腺分叶剜除术治疗良性前列腺增生的疗效观察

Effectiveness of transurethral plasmakinetic lobes-enucleation of prostate in treatment of benign prostatic hyperplasia

  • 摘要: 目的 探讨经尿道等离子前列腺分叶剜除术治疗良性前列腺增生的安全性及有效性。方法 选取2017年9月-2018年5月我院泌尿外科收治的27例良性前列腺增生患者,均由同一名医师行经尿道等离子前列腺分叶剜除术。术后1个月评估该术式治疗良性前列腺增生的安全性及有效性。结果 所有手术均成功实施,患者平均年龄为(63.7±7.3)岁,平均前列腺重量为(64.5±23.9) g,平均手术时间为(64.3±35.4) min,平均切除前列腺重量为(44.5±20.8) g,平均术后血红蛋白降低(1.28±1.12) g/dl,平均留置尿管(66.1±12.4) h,平均住院时间(7.4±2.8) d。术后1个月随访,与术前相比,前列腺特异性抗原水平1.0±0.7) ng/ml vs (3.5±1.6) ng/ml,P=0.009及经直肠前列腺超声所测前列腺重量(21.8±7.7) g vs (64.5±23.9) g,P=0.001显著降低。术后1个月最大尿流率(peak flow rate,Qmax)与术前相比显著提高(17.6±8.4) ml/s vs (5.1±3.1) ml/s,P=0.004。国际前列腺症状评分与生活质量评分与术前相比显著改善(17.5±4.5 vs 8.7±4.5,4.6±0.4 vs 1.3±0.5,P均<0.001)。无患者出现术后尿失禁、膀胱血凝块填塞、尿道狭窄、膀胱颈挛缩等并发症。2例(7.4%)出现尿路感染。1例(3.7%)出院后出现尿潴留,原因可能为逼尿肌收缩力低下导致。结论 经尿道等离子前列腺分叶剜除术治疗良性前列腺增生安全、有效。

     

    Abstract: Objective To discuss the safety and effectiveness of transurethral plasmakinetic lobes-enucleation of prostate for patients with benign prostatic hyperplasia. Methods Totally 27 patients who underwent transurethral plasmakinetic lobes-enucleation of prostate from September 2017 to May 2018 by the same surgeon in our institution were included in this study. Patients were assessed at one month postoperatively to evaluate the safety and effectiveness of this operation. Results All operation was performed successfully. The mean age of patients was(63.7±7.3) years, with mean preoperative prostate weight of(64.5±23.9) g,mean operating time of(64.3±35.4) min and mean resected tissue weight of(44.5±20.8) g. The decrease in hemoglobin after surgery was(1.28±1.12) g/dl, and the mean catheter dwelling time was(66.1±12.4) hours and hospitalization time was(7.4±2.8) days. Patients were assessed at one month postoperatively, and the prostate specific antigen(PSA) level (3.5±1.6) ng/ml vs(1.0±0.7) ng/ml, HR=0.009 and transrectal ultrasound(TRUS) weight (64.5±23.9) g vs(21.8±7.7) g, HR=0.001 reduced significantly. And there was a significant improvement in maximum urinary flow rate(Qmax) (17.6±8.4) ml/s vs(5.1±3.1) ml/s,HR=0.004. Both international prostate symptom score(IPSS) and quality of life(QoL) scores improved significantly IPSS,(17.5±4.5) vs(8.7±4.5); QoL,(4.6±0.4) vs(1.3±0.5); P<0.001, respectively. No patient experienced incontinence, clot retention, urethral stricture and bladder neck contracture. Two patients(7.4%) had urinary tract infection, and one patient(3.7%)experienced urinary retention after discharged because of detrusor under activity. Conclusion Transurethral plasmakinetic lobesenucleation of prostate is a safe and effective method in treatment of benign prostatic hyperplasia.

     

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