TUPKP和TURP治疗良性前列腺增生的对照研究

发布时间：2018-04-09 07:43

本文选题：前列腺增生(BPH)　切入点：经尿道前列腺等离子切除术(TUPKP)　出处：《泰山医学院》2014年硕士论文

【摘要】：目的:评价目前手术治疗前列腺增生(BPH)的方法,即经尿道前列腺等离子切除术(TUPKP)和经尿道前列腺电切术(TURP),包括临床疗效和手术安全性。方法:实验组分为两组,即TURP组和TUPKP组。TURP组,从2011年1月-10月泰山医学院附属邹平县人民医院泌尿外科收治的确诊为BPH的患者中随机抽取110例,行TURP手术治疗;TUPKP组,从2013年1月-2013年10月同科室收治的确诊为BPH的患者中随机抽取140例,行TUPKP手术治疗。应注意2组患者应统一纳入和剔除的标准,并做术前PSA值的常规检测,测量前列腺体积,通过直肠指诊检查明确前列腺有无异常增生结节、大体形态和质地等情况,以及其它术前常规检查。应注意,必须充分了解泌尿系统有无其他病变和病史。在实验中,全面观察2组患者的手术经历时间、手术中出血量、手术结束时血液中钠离子等离子浓度的变化、手术结束后血糖的高低,手术前和手术后1个月分别进行国际前列腺症状评分(IPSS)、残余尿量(RUV)、最大尿流率(Qmax)、生活质量评分(QOL),观察手术并发症及其转归等情况。结果:TUPKP组在平均手术时间,术中出血量,术后平均冲洗时间等均较TURP组明显下降(P0.05);TURP组手术结束时血钠、血糖值与术前比较差异有统计学意义(P0.05),TUPKP组手术结束时血钠及血糖值与术前比较差异无明显的变化(P0.05)。手术后1个月2组间上述指标比较均无明显差异性变化(均P0.05),手术后1个月IPSS、QOL、Qmax、RUV测试值与手术前比较差异均有统计学意义(均P0.01),并且术后各种并发征比较差异均有统计学意义(均P0.05)。结论:TURP、TUPKP均是目前经尿道切除增生前列腺的有效的外科手术治疗方法,均可明显改善下尿路梗阻的相关症状。实验中TUPKP组患者在手术中没有发生电切综合征,手术中出血量较少,实验结果表明手术对机体血糖、血中钠离子浓度无明显影响,手术并发症总发生率明显少于TURP组,因此根据实验结果,TUPKP手术较为安全,是目前经尿道治疗BPH理想的手术方法。但因本试验样本数有限,随访时间较短,需要增大样本量进行对照试验来进一步证实此结论。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of transurethral prostatectomy (TUPKP) and transurethral resection of prostate (TURP) for the treatment of benign prostatic hyperplasia (BPH).Methods: the experimental group was divided into two groups: TURP group and TUPKP group. From January to October 2011, 110 patients with BPH were selected randomly from Urology Department of Zouping County people's Hospital affiliated to Taishan Medical College.From January 2013 to October 2013, 140 patients with BPH were randomly selected and treated with TUPKP.Attention should be paid to the standard of inclusion and exclusion of the two groups, routine examination of preoperative PSA value, measurement of prostate volume, and determination of abnormal hyperplastic nodules, gross morphology and texture of the prostate by rectal digital examination.And other routine preoperative examinations.Attention should be paid to the need to fully understand whether the urinary system has other lesions and history.In the experiment, the time of operation, the amount of blood loss during operation, the concentration of sodium ion and plasma in blood, the level of blood glucose after operation were observed.International prostatic symptom score (IPSS), residual urine volume (RUV), maximum flow rate (Qmax), quality of life (QOL) were evaluated before operation and 1 month after operation respectively. The complications and prognosis of the operation were observed.Results compared with the TURP group, the average operative time, intraoperative blood loss and postoperative irrigation time in the TUPKP group were significantly lower than those in the TURP group, and the blood sodium was decreased at the end of the operation in the TUPKP group.There was no significant difference in blood sodium and blood glucose between the two groups at the end of operation.There was no significant difference in the above indexes between the two groups at one month after operation (all P 0.05), and the RUV values of IPSS QOLQmax Qmax 1 month after operation were significantly different from those before operation (all P 0.01), and there were significant differences in all kinds of complications after operation.Statistical significance (P 0.05).Conclusion TURP- TUPKP is an effective surgical treatment for prostatectomy of prostatic hyperplasia by transurethral resection, which can obviously improve the symptoms of lower urinary tract obstruction.In the TUPKP group, there was no electrocution syndrome and less bleeding during the operation. The results showed that the operation had no significant effect on blood glucose and serum sodium concentration, and the total incidence of complications was significantly lower than that in the TURP group.Therefore, according to the experimental results, TUPKP is safe and is an ideal method for transurethral treatment of BPH.However, due to the limited sample size and short follow-up time, it is necessary to increase the sample size to further confirm this conclusion.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699.8

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