作　　者： ; ; ; ; ; ;

机构地区： 广州医科大学

出　　处： 《岭南现代临床外科》 2017年第4期444-451,共8页

摘　　要： 目的探讨经尿道等离子双极前列腺剜除术(PKEP)与经尿道等离子双极前列腺电切术(PKRP)治疗体积>60 m L良性前列腺增生(BPH)的安全性与有效性。方法检索国内外各大常用数据库中比较PKEP与PKRP治疗体积>60 m L BPH的随机对照研究(RCT),检索日期为2012年1月1日至2017年3月2日,按照纳入排除标准进行文献筛选和数据提取,并进行文献质量评价,使用Rev Man 5.3软件进行Meta分析。结果与PKRP相比,PKEP的前列腺切除质量较多{WMD=15.29,95%CI(9.18,21.40),P<0.001},手术时间较短{WMD=-17.44,95%CI(-28.69,-6.19),P=0.002},留置导尿管时间较短{WMD=-26.51,95%CI(-36.49,-16.54),P<0.001},术中出血量较少{WMD=-77.82,95%CI(-120.90,-34.74),P<0.001},住院天数较少及术后最大尿流率较大,但后两者敏感性较低。PKEP与PKRP术后并发症发生率无统计学差异。结论比较PKEP与PKRP治疗体积>60 m L BPH,PKEP切除前列腺增生腺体更完全,所需手术时间短,留置导尿管时间较短,术中出血量少,较PKRP安全有效,但由于原始研究质量较低,后期仍需大量高质量、大样本RCT验证后方可进一步临床推广。 Objective To evaluate the safety and efficacy of plasmakinetic enucleation of prostate（PKEP）vs plasmakinetic resection of prostate（PKRP）in treating benign prostatic hyperplasia（BPH）which volume was larger than 60 ml. Methods Databases were searched from 2012/01/01 to 2017/03/02 for collecting the randomized controlled trials about PKEP vs PKRP for the treatment of BPH with volume larger than 60 ml,and then selected the literatures using bringing in and ruling out standard,assessing them and extracting data. Meta-analysis was performed by using the Rev Man 5.3. Results Compared with PKRP,PKEP had more resection hyperplastic tissue（WMD=15.29,95%CI：9.18,21.40,P〈0.001）,shorter operation time（WMD=-17.44,95% CI：-28.69,-6.19,P=0.002）,shorter catheter time（WMD=-26.51,95% CI：-36.49,-16.54,P〈0.001）,less intraoperative bleeding（WMD=-77.82,95% CI：-120.90,-34.74,P=0.0004）,but there was no significant difference in the incidence ofpostoperative complications between PKEP and PKRP. Conclusion Compared with PKRP for thetreatment of BPH which volume is larger than 60 ml,PKEP had more resection hyperplastic tissue,shorter operation time,shorter catheter time,less intraoperative bleeding. But because the originalresearch quality is poor,higher quality,large sample RCT studies are need before clinic promotion.

关 键 词： 良性前列腺增生 经尿道等离子双极前列腺剜除术 经尿道等离子双极前列腺切除术 分析

领　　域： []