摘要
目的探讨经尿道前列腺部分电切术治疗高危重度前列腺增生症（BPH）的安全性和有效性。方法对148例高危重度BPH患者采用经尿道前列腺部分汽化电切（TUVP）治疗（切除前列腺中叶和一侧叶，另一侧叶不切除），观察手术时间、术中出血量和术后继发性出血的发生率以及尿流率变化。结果切除组织重量25．1～86g（平均45g），手术时间45～87min（平均56min）。术中平均出血56ml（52ml～135m1），4例术后1d残余腺体出血，开放手术止血，中转手术率1／37（2．7％）；2例术毕发生血氧饱和度下降，经对症治疗后缓解；无手术死亡病例及其他严重并发症发生；国际前列腺症状评分由术前平均30．6分下降至术后8．5分，生活质量评分（QOL）由术前平均5．2分下降至术后1．7分，平均最大尿流率17．8ml（16．2～24．3m1）。结论经尿道前列腺部分汽化电切术治疗高危重度前列腺增生安全、有效，可明显缩短手术时间、减少出血和术中并发症，但对残留腺体创面要彻底止血，预防残留腺体出血。手术成功的关键是形成通道。
Objective To investigate the safety and effect of partial transurethral electrovaporization in the treatment of high risk benign prostatic hyperplasia （BPH）. Methods One hundred and forty-eight cases of high risk BPH undergoing partial transurethral electrovaporization of prostate were investigated. The operation time, the bleeding volume, the secondary hemorrhage rate and the maximum urinary flow rate were evaluated. Results The weight of resected tissue was 25.1 ～ 86 g （ average 45 g）. Operation time was 45-87 min （ average 56 min）. 4 cases with hemorrhage of remain glandular organ underwent surgical hemostasis. Transit surgical rate wasl/37 （2.7%） , 2 cases had light TURP syndrome. No serious side effects occured. The IPSS and QOL decreased after operation and the maximum urinary flow rate was greatly improved. Conclusion Partial transurethral electrovaporization of prostate is a safe and effective approach of treating large volume BPH. It provides short operation time, little blood loss and few complications. To prevent the bleeding of remain glandular organ, complet haemostasis is needed. The conerstone of the procedure is the formation of a tunnel.
出处
《中国医药》
2009年第10期783-785,共3页
China Medicine
关键词
前列腺增生症
经尿道前列腺汽化电切术
老年人
Benign prostatic hyperplasia
Transurethral electrovaporization of prostate
Elderly
