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。
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.
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