【摘要】 目的观察"四步法"保留膀胱颈等离子前列腺剜除术治疗前列腺增生(BPH)的效果。方法采用历史对照研究,将我院2017年1月至2017年10月采用"四步法"保留膀胱颈等离子前列腺剜除术治疗的86例BPH患者设为观察组,2016年3月至2016年12月83例采用经尿道双极等离子前列腺切除术的BPH患者设为对照组,比较两组手术相关指标,患者术后均随访6个月,评价两组症状改善情况,记录术后尿道狭窄、尿失禁等并发症发生率。结果观察组腺体切除率为(74.63±10.92)%,明显大于对照组的(60.08±12.49)%(P<0.05)。观察组与对照组术后残余尿分别为(18.43±2.19)ml、(19.27±2.65)ml,国际前列腺症状评分分别为(7.18±0.39)分、(7.56±0.42)分,均明显低于术前(P<0.05)。观察组术后6个月最大尿流率为(19.63±2.71)ml/s,明显大于术前的(7.51±0.93)ml/s,且大于对照组的(18.17±2.46)ml/s(P<0.05)。观察组术中并发症发生率为2.33%,术后并发症发生率为24.42%,均低于对照组的12.05%、53.01%(P<0.05)。结论 "四步法"保留膀胱颈等离子前列腺剜除术可切除更多的增生腺体,并发症发生率低,是治疗BPH安全、有效的方法。更多还原

【Abstract】 Objective To observe the effect of "four-step" bladder neck-sparing plasma prostatectomy in the treatment of benign prostatic hyperplasia(BPH). Methods 86 patients with BPH who underwent "four-step" bladder neck-sparing plasma prostatectomy in our hospital from January 2017 to October 2017 were enrolled in the observation group, and 83 patients with BPH who underwent transurethral bipolar plasma prostatectomy from March 2016 to December 2016 were enrolled in the control group. The operation time, gland resection time, postoperative irrigation time, indwelling catheter time and hospitalization time were compared between the two groups. All patients were followed up for 6 months. The residual urine volume(RUV), maximum urinary flow rate(Qmax), international prostate symptom score(IPSS) were used to evaluate the improvement of symptoms and urethral stricture. The incidence of complications such as urinary incontinence was compared. Results The rate of gland excision in the observation group was higher than that in the control group[(74.63±10.92)% vs(60.08±12.49)%(P<0.05)]. The RUV and IPSS of the observation group and the control group after operation were(18.43±2.19) ml,(19.27±2.65) ml and(7.18±0.39),(7.56±0.42) respectively, which were significantly lower than those before operation(P<0.05). The Qmax of observation group 6 months after operation was(19.63±2.71) ml/s, which was significantly higher than that of preoperative(7.51±0.93) ml/s and control group(18.17±2.46) ml/s(P<0.05). The incidence of intraoperative complications and postoperative complications in the observation group were 2.33% and 24.42% respectively, which were lower than those in the control group(12.05% and 53.01%),(P<0.05). Conclusion Four-step bladder neck-sparing plasma prostatectomy is a safe and effective method for the treatment of benign prostatic hyperplasia.更多还原