摘要
目的:探讨BPH患者组成变化和个人学习曲线对经尿道前列腺电汽化切除术(TUVRP)疗效的影响。方法:回顾性分析由一个医生实施的270例TUVRP的临床资料,其中A组为早期100例,B组为最后170例。分析项目包括患者年龄、前列腺体积、BPH并发症、影响排尿功能疾病、手术方式和时间、ASA体格情况分级、手术并发症、IPSS评分、最大尿流率等。结果:与A组相比,B组年龄提高4.35岁(P<0.001),前列腺体积增加23.35 g(P<0.001),伴有的BPH并发症、影响排尿功能疾病、全身性疾病显著增加,无中转开放手术患者;手术时间减少18.54min(P<0.001),术前和术后血红蛋白含量显著减少;膀胱冲洗、止血剂应用、围术期输血、手术并发症明显减少,无死亡和二次手术患者。两组术后IPSS评分、QOL指数、最大尿流率、平均尿流率均有明显改善。结论:近年来BPH手术患者出现高龄化趋势,大多出现严重并发症后才接受手术。随着患者数量的积累,术者的操作技能逐步提高,从而获得更好的疗效。TUVRP是一种有效的BPH治疗方法,宜普及推广。
Objective： To evaluate the alteration about composition of surgical patients with benign prostatic hyperplasia （BPH） and individual learning curve in the performing transurethral vaporization resection of prostate （TUVRP） on the efficiency. Methods：The clinical data from 270 patients who underwent TUVRP by one surgeon in recent twelve years was studied. Group A, earlier 100 cases; group B, late 170 cases. It was analyzed the fac tots of age, prostate volume, BPH complications, accompanied diseases with impact to urinary function, surgical method, operating time, American Society of Anesthesiologists（ASA） grade, surgical complications, IPSS score, maximum urine flow rate and so on. Results：In group I3, average age was increased 4.35 years（P〈0. 001） ; prostate volume was increased 23.35 g（P〈0. 001）;accompanied 13PH complications, diseases with impact to urinary function and systemic diseases were significantly increased; there was no open operation case and operating time was decreased 18.54 minutes（P〈0. 001）; and preoperative and postoperative hemoglobin levels were significantly decreased. Postoperative continuous bladder irrigation, application of hernostatic agents, perioperative blood transfusion and surgical complications in group 13 were significantly reduced, compared with that in group A, meanwhile there was no mortality and reoperation case. Postoperative IPSS score, QOL index, maximum urine flow rate and average urine flow rate were significantly improved in both two groups. Conclusions：The tendency of aging is presented in surgical patients with BPH and most cases receive surgery only when severity BPH compositions appear in recent years. The surgeon＇s skill will be continuously improved so that get better efficacy as the performed case is increased. TUVRP is an effective therapeutic method to BPH and easy to popularized application in clinical.
出处
《临床泌尿外科杂志》
2008年第12期895-898,共4页
Journal of Clinical Urology
关键词
前列腺增生症
经尿道前列腺电汽化切除术
学习曲线
疗效
Benign prostatic hyperplasia
Transurethral vaporization resection of prostate
I.earning curve
Efficacy
