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目的 :探讨经尿道腔内手术及传统开放手术治疗前列腺增生症 (BPH)的彻底性 ,对比不同方法的疗效。方法 :将BPH患者 1 2 6例 ,随机分成腔内组和开放组。测量切除腺体重量及术前B超估计重量 ,求得腺体切除率。术后 3个月随访 ,根据IPSS评分、最大尿流率、并发症和住院时间等 ,比较两类术式的疗效。结果 :腔内组95例 ,平均切除腺体 (2 5 .8± 1 6 .7) g ,平均腺体切除率6 1 .4 % ;开放手术组 31例 ,平均切除 (39.6± 30 .8) g ,平均腺体切除率 70 .8% ;手术疗效二组间差异无显著性意义 (P >0 .0 5 )。而术后住院时间等 ,腔内组明显短于开放组 (P <0 .0 5 )。结论 :腔内手术近期疗效与开放手术类似 ,效果好 ,并发症少 ,但对增生腺体切除率偏低 ,可能影响远期疗效。等离子双极汽化前列腺切除术采用腔内分隔切开逆行剥离法切除增生腺体 ,有望达到开放手术顺行剥离切除腺体的效果。
Objective: To investigate the thoroughness of transurethral endoscopic surgery and traditional open surgery in the treatment of benign prostatic hyperplasia (BPH) and to compare the curative effects of different methods. Methods: One hundred and twenty-six patients with BPH were randomly divided into intraluminal group and open group. Measurement of resected gland weight and preoperative B-estimated weight, obtained gland resection rate. After 3 months of follow-up, according to the IPSS score, the maximum uroflow rate, complications and length of stay, compared the efficacy of two types of surgery. Results: In the group of 95 cases, the average number of resected glands was (25.8 ± 16.7) g, the average gland resection rate was 61.4%. In the open operation group, 31 cases were resected (39.6 ± 30.8) ) g, the average gland resection rate was 70.8%. There was no significant difference between the two groups in operative efficacy (P> 0.05). The postoperative hospital stay, intracavitary group was significantly shorter than the open group (P <0. 05). CONCLUSION: The short-term effect of endovascular surgery is similar to that of open surgery. The effect is good with fewer complications. However, the resection rate of proliferative glands is low, which may affect the long-term curative effect. Plasma bipolar vaporization of the prostate resection using intracavitary resection incision retrograde dissection of proliferative glands, is expected to reach the open surgery in the removal of the glands resection effect.