【摘要】 目的回顾分析良性前列腺增生症(BPH)4种不同术式的疗效及术后并发症。方法1995年5月～2005年1月,我院共手术治疗BPH患者975例,其中经膀胱前列腺切除术(开放手术)治疗463例,经尿道前列腺电切术(TURP)26例,经尿道前列腺汽化电切术(TVP)374例,TURP+TVP联合37例,经尿道前列腺等离子电切术(PKRP)75例,术后随访0．5年至10年。结果开放手术组的平均腺体切除率(71．1±7．5)%,术中出血量和恢复时间均显著高于其他腔内治疗组(P＜0．05)。各组术后的最大尿流率(Qmax),膀胱剩余尿量(PRV)均明显改善,组间无明显差异(P＞0．05)。并发症率为开放手术组17．1%、TURP 11．5%、TURP+TVP 8．1%、TVP 7．5%、PKRP 8．0%。常见并发症是继发性出血、感染、尿道狭窄、尿失禁、膀胱痉挛等。开放组中2例死亡,其它组无死亡病例。再手术率为开放手术组1．3%、TURP 11．5%、TURP+TVP 5．4%、TVP 4．0%、PKRP 5．3%。结论各种术式的近期疗效基本相似,腔内手术创伤较小,患者恢复较快,但切除率偏低,可能影响远期疗效；开放手术适于前列腺增生较大、并发膀胱病变的患者。更多还原

【Abstract】 Objective To review the clinical outcome and complications of variant prostatectomy for benign prostatic hyperplasia.Methods During 1995/5 to 2005/1,four types of prostatectomy were performed in 975 patients with benign prostatic hyperplasia,including 463 cases of open transvesical prostatectomy,26 transurethral resection of the prostate (TURP),374 transurethral electrovaporization of the prostate (TVP),37 combination of TURP and TVP,and 75 bipolar plasmakinetic resection of prostate (PKRP).Results The proportion of prostate resection (71.1±7.5)%,hemorrhage,and hospitalization period increased significantly in open prostatectomy (P＜0.05).The other indexes such as Qmax and PRV improved obviously after operation and showed no significant differences between groups (P＞0.05).The rate of complications was 17.1% in open prostatectomy group,11.5 % in TURP,8.1% in TURP+TVP,7.5% in TVP,and 8.0% in PKRP.The main complications were hemorrhage,infection,urethral stricture,and urinary incontinence.In the open prostatectomy,there were 2 cases of death and no death happened in the other groups.There was 1.3 % of readmission in open prostatectomy group,11.5% in TURP,5.4% in TURP+TVP,4.0% in TVP,and 5.3% in PKRP.Conclusion The endoscopic treatments result in less trauma and quicker recovery,but with lower proportion of prostate resection,which may influence the outcome over a long term.Open prostatectomy is suitable for larger hyperplasia of prostate,or with lesion in bladder.更多还原