CAJ | 학술논문

目的：：探讨“四步法”保留膀胱颈等离子前列腺剜除术(FSMPKEP)治疗前列腺增生症(BPH)的安全性和有效性.方法：200例BPH 患者根据手术方法分为2组，行 FSMPKEP 术80例与经尿道双极等离子前列腺切除术(PKRP)120例，记录患者围手术期和术后6个月有关指标并进行统计学分析.结果：术前两组一般情况比较差异无统计学意义(P ＞0.05).手术时间、术后平均冲洗时间、留置尿管时间和住院时间， FSMPKEP 组少于 PKRP 组，前者切除腺体率多于 PKRP 组(P ＜0.05).术后6个月两组在国际前列腺症状评分(IPSS)、生活质量(QOL)评分、剩余尿(PVR)、尿失禁以及尿道狭窄等并发症方面差异无统计学意义(P ＞0.05).FSMPKEP 组最大尿流率(Qmax )优于 PKRP 组(P ＜0.05)，分别为(19.50±2.32)ml/s 和(18.60±2.58)ml/s；FSMPKEP 组逆行射精的发生率低于 PKRP 组(P ＜0.05)，分别为22.50％(18/80)和68.33％(82/120).结论：FSMPKEP 在治疗 BPH 方面与 PKRP 相比有相同的有效性和安全性，同时前者具有术后恢复时间短、切除组织多和逆行射精发生率低等优势，是安全、有效和较为理想的 BPH 治疗方法.
목적：：탐토“사보법”보류방광경등리자전렬선완제술(FSMPKEP)치료전렬선증생증(BPH)적안전성화유효성.방법：200례BPH 환자근거수술방법분위2조，행 FSMPKEP 술80례여경뇨도쌍겁등리자전렬선절제술(PKRP)120례，기록환자위수술기화술후6개월유관지표병진행통계학분석.결과：술전량조일반정황비교차이무통계학의의(P ＞0.05).수술시간、술후평균충세시간、류치뇨관시간화주원시간， FSMPKEP 조소우 PKRP 조，전자절제선체솔다우 PKRP 조(P ＜0.05).술후6개월량조재국제전렬선증상평분(IPSS)、생활질량(QOL)평분、잉여뇨(PVR)、뇨실금이급뇨도협착등병발증방면차이무통계학의의(P ＞0.05).FSMPKEP 조최대뇨류솔(Qmax )우우 PKRP 조(P ＜0.05)，분별위(19.50±2.32)ml/s 화(18.60±2.58)ml/s；FSMPKEP 조역행사정적발생솔저우 PKRP 조(P ＜0.05)，분별위22.50％(18/80)화68.33％(82/120).결론：FSMPKEP 재치료 BPH 방면여 PKRP 상비유상동적유효성화안전성，동시전자구유술후회복시간단、절제조직다화역행사정발생솔저등우세，시안전、유효화교위이상적 BPH 치료방법.
Objective:To explore the safety and efficiency of four-step method transurethral plasmakinetic enu-cleation of prostate with preservation of the bladder neck (FSMPKEP)for benign prostatic hyperplasia (BPH ). Methods:200 patients with BPH were divided into FSMPKEP group (n =80)and transurethral plasmakinetie resec-tion of prostate (PKRP)group (n =120).The clinical indicators of perioperative and 3-month postoperative period were analyzed.Results:There was no significant difference in preoperative factors between the two groups (P >0.05).The mean operative time,bladder irrigating time,catheterization time and hospital stay were shortened in the FSMPKEP group as compared with those in the PKRP group (P <0.05).The mean resected tissues weighted more in the FSMPKEP group than in the PKRP group (P <0.05).During the follow up period of 6 months,there was no significant difference in international prostate symptom scores (IPSS),quality of life (QOL),postvoid residual (PVR),urinary incontinence and urethral stricture between the two groups (P > 0.05 ).Maximum urinary flow (Qmax )in FSMPKEP group (1 9.50 ± 2.32 mL/s)was increased as compared with PKRP group (18.60 ± 2.58 mL/s)(P <0.05).The incidence rate of retrograde ejaculation in FSMPKEP group (22.50%,18/80)was signifi-cantly lower than in PKRP group (68.33%,82/120)(P <0.05).Conclusions:FSMPKEP is as effective as PKRP for the treatment of BPH,which has the characteristic of short postoperative recovery time,more removal of the prostate tissue and low incidence rate of retrograde ejaculation at the same time.FSMPKEP is safe,effective and ide-al minimally invasive treatment procedure for BPH.