【摘要】 目的探讨经尿道前列腺等离子剜除术患者前列腺体积变化及临床意义。方法回顾性分析2010年1月—2013年12月期间于本院接受手术治疗的90例前列腺增生患者的临床资料。比较经耻骨上前列腺摘除术(suprapublic prostatectomy,SPP)组和经尿道前列腺等离子剜除术(transurethral enucleation with bipolar,TUEB)组手术前后前列腺体积、国际前列腺症状评分(international prostate symptom score,IPSS)、最大尿流率(Qmax)和残余尿(residual urine,RU)等的变化。结果两组术后前列腺影像表现接近,均可看到手术达到前列腺外科包膜层面。两组术前和术后前列腺体积比较,差异无统计学意义(P>0.05);TUEB组术后前列腺体积较术前显著减少,差异具有统计学意义(P<0.001),同样,SPP组术后前列腺体积较术前显著减少,差异具有统计学意义(P<0.001)。TUEB和SPP术后所残留的腺体(实为外科包膜)体积均占术前体积的36%左右,残留前列腺体积主要为外科包膜。两组术后1月IPSS、Qmax和RU等疗效指标较术前明显改善(P<0.05),但组间疗效比较,差异无统计学意义(P>0.05)。结论经尿道前列腺剜除手术以外科包膜为界,可以有效解除前列腺增生患者下尿路梗阻症状,且安全性高。更多还原

【Abstract】 Objective To investigate the change of prostate volume and its clinical significance of transurethral plasma kinetic enucleation of prostate. Methods The clinical data of 90 patients with hyperplasia of prostate undergoing surgical treatment in our hospital between January 2010 and December 2013 were retrospectively analyzed. The prostate volume,international prostate symptom score(IPSS),maximum urinary flow rate(Qmax)and residual urine(RU)were compared between transurethral enucleation of prostate with bipolar system(TUEB) group and suprapubic prostatectomy(SPP)group. Results Postoperative prostate images in both groups were close to prostate surgery capsule layers. There was no significant difference in prostate volume between two groups before opeation and after operation(P>0.05). The prostate volume after operation was significantly smaller than that before operation both in TUEB group and SPP group(P<0.001). In TUEB group and SPP group,postoperative residual gland volume accounted for about 36%of the preoperative volume,and the residual prostatic volume was mainly surgical capsule. IPSS,Qmax and RU in each group were significantly improved 1 month after operation(P<0.05),but there was no significant difference in curative effect between two groups(P>0.05). Conclusion Transurethral prostate enucleation by a surgical capsule can effectively relieve lower urinary tract obstruction symptoms in patients with prostate hyperplasia,which has high safety.更多还原