摘要
目的总结经尿道前列腺电切除术(TURP)治疗前列腺增生症(BPH)的经验.方法采用TURP治疗BPH 360例.结果平均手术时间:I度BPH 68.4min,II度84.9min,III度104.4min,IV度191.7min.平均切除克数:I度BPH15.4 g,II度26.3 g,III度39.5 g,IV度59.7 g.术中输血率及平均输血量:I度BPH0 %,II度17.9 %、73.8 ml,III度43.9 %、175.8 ml,IV度85.7%、600 ml.III、IV度BPH与I、II度BPH相比,平均输血量有高度显著性差异(P<0.01).术中包膜穿孔3例(0.8 %)、经尿道前列腺电切除综合征(TURPS)2例(0.5 %)、中转开放手术1例(0.3%).半数病人随访1月～5年,均排尿良好.7.5%患者出现并发症.2例病人术后1周猝死(0.5%).结论不同大小的BPH应根据其增生特点,TURP时各有侧重,I、II度BPH尤适于TURP.高危III、IV度BPH病人,即使通道式TURP也应慎用.术中采取措施得当,TURP时间完全可以突破1小时的限制而不会发生TURPS.
Aim To summarize the experience of transurethral resection of benign prostatic hyperplasia（ BPH）. Methods Clinical data of 360 cases of BPH by transurethral resection were analysed retrospectively. Results The mean operative time： Ⅰ BPH 68.4 min, Ⅱ BPH 84.9 min, Ⅲ BPH 104.4 min, Ⅳ BPH 191.7 min. the mean grams of resection：Ⅰ BPH 15.4 g, Ⅱ BPH 26.3 g, Ⅲ BPH 39.5g, Ⅳ BPH 59.7 g. The rate and mean amount of blood transfusion in operation： Ⅰ BPH 0, Ⅱ BPH 17.9% and 73.8 ml, Ⅲ BPH 43.9% and 175.8 ml, Ⅳ BPH 85.7% and 600ml. There were high significant difference between Ⅲ , Ⅳ BPH and Ⅰ,Ⅱ BPH of average blood transfusion amount（p 〈 0.01 ）. Perforation of the prostatic capsule occurred in 3 （0.8%） ,TURPS in 2 （0.5%） , changed to transvesical prostatectomy in 1 （0.3%） , 50% patients were followed-up 1 month -5 years,all the patients had a high quality of life, but there were 7.5% complications 2. （0.5%） patients fell sudden death after one week of TURP. Conclusions The key of TURP varied with the difference of the volumes and hyperplasic features of BPH, Ⅰ,Ⅱ BPH was especially feasible for TURP. Even the tunnel TURP was not recommended for Ⅲ,Ⅳ BPH of high risk patients. The time of TURP could go beyond 60 min and no TURPS would occur if correct measures were taken in the operation.
出处
《安徽医药》
CAS
2005年第9期685-686,共2页
Anhui Medical and Pharmaceutical Journal
