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

外科研究与新技术 ›› 2016, Vol. 5 ›› Issue (1): 7-10.

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

杨鲲,陈向东,丁满棠,汤海

上海市静安区中心医院

收稿日期:2015-12-31 修回日期:2016-01-24 出版日期:2016-03-28 发布日期:2016-03-08
通讯作者: 杨鲲 E-mail:yangkun76@msn.com
基金资助:
上海市卫生局 “前列腺外科包膜在前列腺增生腔镜治疗中的意义”课题项目

Prostate volume change and its clinical significance of transurethral plasma kinetic enucleation of prostate

Received:2015-12-31 Revised:2016-01-24 Online:2016-03-28 Published:2016-03-08

摘要/Abstract

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2010.1至2013.12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（SPP）和经尿道前列腺等离子剜除术（TUEB）组手术前后前列腺体积、国际前列腺症状评分（IPSS）、最大尿流率（Qmax）和残余尿（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组术后前列腺体积明显较术前减少，差异有显著统计学意义（P<0.001），同样，SPP组术后前列腺体积明显较术前减少，差异有显著统计学意义（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等疗效指标明显较术前改善(P<0.05)，但组间疗效比较，差异无统计学意义（P>0.05）。结论　经尿道前列腺等离子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。该手术技术未来有进一步发展空间，远期甚至可能撼动经尿道前列腺电切术（TURP）的“金标准”地位。

关键词: 良前列腺增生, 前列腺外科包膜, 前列腺体积, 效果

Abstract: Objective To study prostate volume change 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 during 2010.1 to 2013.12 were retrospectively analyzed. Prostate volume and international prostate symptom score (IPSS), maximum urinary flow rate (Qmax) and residual urine (RU) of TUEB and SPP groups were compared. Results Postoperative prostate images in two groups were both close to prostate surgery capsule layers. Between preoperative and postoperative prostatic volumes in two groups, there were no statistically significant difference (P>0.05); In TUEB group, there was significant difference (P<0.001) in postoperative prostate volume to preoperative prostate volume. Similarly, in SPP group postoperative prostate volume was significantly difference(P<0.001) to preoperative prostate volume. In TUEB and SPP groups, postoperative residual gland volume accounted for about 36% of the preoperative volume, and residual prostatic volume mainly was surgical capsule. Postoperative IPSS, Qmax and RU in each group were improved (P<0.05), but there was no statistically significant difference between curative effect of the two groups(P>0.05). Conclusion Transurethral prostate enucleation by a surgical capsule, can effectively relief prostate hyperplasia symptoms in patients with lower urinary tract obstruction, and have high safety. The skill of transurethral enucleation of prostate may replace TURP as the “golden standard” in the surgical treatment of BPH in the future.

Key words: Benign prostatic hyperplasia, Prostate surgery capsule, Prostate volume, Effect

杨鲲陈向东丁满棠汤海. 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[J]. 外科研究与新技术, 2016, 5(1): 7-10.

参考文献

[1] 陈书尚,石良冲,朱凌峰等.三种手术方式治疗大体积前列腺增生症的疗效比较[J].医学临床研究,2013,30(3):433-436.
[2] 杨鲲,陈向东,高进等.前列腺外科包膜的病理组成研究及其临床意义探讨[J].医学临床研究,2011,28(5):807-809.
[3] 陈向东,王忠,齐隽等. 经尿道前列腺剜除术中对前列腺包膜和外科包膜性状的观察[J?.中国男科学杂志, 2009,23(5):43-45.
[4] Rick, F.G.,Abi-Chaker, A.,Szalontay, L. et al.Shrinkage of experimental benign prostatic hyperplasia and reduction of prostatic cell volume by a gastrin-releasing peptide antagonist[J].Proceedings of the National Academy of Sciences of the United States of America,2013,110(7):2617-2622.
[5] Wang,X.,Lin,W.-J.,Izumi,K. et al.Increased infiltrated macrophages in benign prostatic hyperplasia (BPH): Role of stromal androgen receptor in macrophage-induced prostate stromal cell proliferation[J].The Journal of Biological Chemistry,2012,287(22):18376-18385.
[6] Barve, I.J.,Chen, L.-H.,Wei, P.C.P. et al.Enantioselective synthesis of (-)-(R) Silodosin by ultrasound-assisted diastereomeric crystallization[J].Tetrahedron,2013,69(13):2834-2843.
[7] Xiao Gu,Kurt Strom,Massimiliano Spaliviero et al.Does prostate configuration affect the efficacy and safety of GreenLight HPS? laser photoselective vaporization prostatectomy (PVP)?[J].Lasers in medical science,2013,28(2):473-478.
[8] Parsons,J.K.,Sarma,A.V.,McVary,K. et al.Obesity and benign prostatic hyperplasia: Clinical connections, emerging etiological paradigms and future directions[J].The Journal of Urology,2013,189(1S):S102-S106.
[9] Kahokehr,A.,Vather,R.,Nixon,A. et al.Non-steroidal anti-inflammatory drugs for lower urinary tract symptoms in benign prostatic hyperplasia: Systematic review and meta-analysis of randomized controlled trials[J].BJU international,2013,111(2):304-311.
[10] 陈斌,郑嘉欣,张开颜等.经尿道前列腺剜除术与电切术治疗不同质量良性前列腺增生的前瞻性研究[J].中华泌尿外科杂志,2013,34(8):608-612.
[11] 王朝,盛玉文,刘奔等.经尿道前列腺等离子腔内剜除术治疗大体积良性前列腺增生的临床疗效[J].北京医学,2014,36(2):102-105.
[12] Gravas,S.,DeLaRosette,J.J..Investigational therapies targeted to the treatment of benign prostatic hyperplasia[J].Expert opinion on investigational drugs,2013,22(3):357-368.

[1]	笪波, 徐文海. 腹腔镜疝修补术治疗成人腹股沟疝的临床疗效观察[J]. 外科研究与新技术, 2021, 10(1): 19-21.
[2]	王春球, 李玉勤, 孟宪国, 陈应超, 钟雪瑜. 输尿管镜下气压弹道碎石术治疗输尿管中下段结石并发感染患者的临床效果[J]. 外科研究与新技术, 2020, 9(4): 234-236.
[3]	梁雪景, 马瑞芳, 阮伊莎. 基于目视管理理论的图示法在学龄期扁桃体切除术患儿中的应用效果[J]. 外科研究与新技术, 2020, 9(3): 214-218.
[4]	童明秀, 郝会, 蔡幼群, 魏妙寿. 门诊孕产妇应用一站式护理服务的应用效果[J]. 外科研究与新技术, 2020, 9(3): 219-221.
[5]	古桂花, 欧阳花, 张雄文, 罗敏. 术后粘连性肠梗阻应用中频导药仪护理效果[J]. 外科研究与新技术, 2020, 9(2): 146-148.
[6]	黄启豪. 自动痔疮套扎术联合地奥司明在混合痔临床治疗中的应用[J]. 外科研究与新技术, 2020, 9(1): 35-38.
[7]	杨华. CBCT在口腔外科阻生牙拔除术中的应用价值[J]. 外科研究与新技术, 2020, 9(1): 39-41.
[8]	桑鸿雁, 张敏. 腹腔镜疝修补术治疗腹股沟疝的效果分析[J]. 外科研究与新技术, 2019, 8(4): 234-236.
[9]	堵晓英. 腹腔镜下子宫肌瘤剥除术、全子宫切除术及次全子宫切除术对患者术后卵巢功能/性功能影响的对比[J]. 外科研究与新技术, 2019, 8(4): 240-243.
[10]	彭柳花, 贾雄, 李崇彪. 复杂性肛瘘两种手术方式的临床疗效对比分析[J]. 外科研究与新技术, 2019, 8(3): 154-156.
[11]	许雪娜, 田皇华. 超声引导下肌间沟与腋路入路行臂丛神经阻滞在桡骨远端骨折手术中应用比较[J]. 外科研究与新技术, 2019, 8(3): 160-162.
[12]	翁海兵, 沈银奎, 钱声华. 前列腺突入膀胱程度对前列腺增生患者前列腺等离子电切术后效果的预测评估作用[J]. 外科研究与新技术, 2019, 8(3): 183-186.
[13]	刘曙光, 袁修翠. 腹腔镜胃癌根治术辅助热灌注化疗治疗进展期胃癌的效果分析[J]. 外科研究与新技术, 2018, 7(4): 232-234.
[14]	叶锦寒. 完全经乳晕入路腔镜良性甲状腺瘤切除术与开放手术的临床分析对比研究[J]. 外科研究与新技术, 2018, 7(4): 263-265.
[15]	王海, 谷丽. 探讨应用CO₂激光治疗早期声门型喉癌临床效果[J]. 外科研究与新技术, 2018, 7(1): 45-47.