摘要
目的观察膀胱造瘘低压灌注下经尿道双极等离子前列腺剜除术（TUERP）治疗前列腺增生（BPH）的临床效果。方法64例BPH患者分成两组，观察组行膀胱造瘘低压灌注下TUERP，对照组行常规TUERP。观察并比较两组心率、血氧饱和度、静脉血清钠、手术时间、术中出血量、术后留置导尿管时间、前列腺重量、术后住院时间，比较术后3个月国际前列腺症状评分（IPSS）、最大尿流率（Qmax）、残余尿量（PRV）、生活质量评分（QOL）的变化。结果术后对照组心率、血氧饱和度、静脉血清钠与术前比较，差异有统计学意义（P〈0．05）。观察组各指标变化不明显，差异均无统计学意义（P〉0．05）。观察组手术时间明显短于对照组，术中出血量和术后住院时间明显低于对照组，两组比较差异均有统计学意义（P〈0．05），两组切除前列腺重量、术后导尿管留置时间比较，差异无统计学意义（P〉0．05）。术后3个月两组PVR、Qmax、IPSS、QOL与术前比较，两组差异均有统计学意义（P〈0．01）。术后观察组IPSS、QOL与对照组比较，差异有统计学意义（P〈0．05）。并发症发生率低。结论膀胱造瘘低压灌注下行TUERP，能降低TURS的发生，手术连贯进行，安全高效，并发症少。
Objectives To analyze the clinical features and pathological features of patients diagnosed as renal amyloidosis, and to improvethe current understanding of the disease and reduce the rate of misdiagnosis. Meth- ods Seven patients were diagnosed as renal amyloidosis based on the pathologic results gained from the aspiration samples of kidney and specific dyeing （ Congo red dye and potassium permanganate stain） ,their clinical manifesta- tions, laboratory examination, echocardiography, abdominal ultrasound, pathologic results during their hospitalization were retrospectively analyzed. Results The clinical manifestations of 8 patients were nephrotic syndrome（NS） ,four cases had have a therapy of hormone, but NS showed no significant improvement, three case showed renal insuf- ficiency, two cases have been developed to uremia, K, h chain were detected in the blood of two cases ; the proportion of the plasma cells were elevated in 3 cases of patients among the four bone marrow biopsy patients ; varying degrees of glomerular injury were found, while accompanied by renal interstitial and vascular damage. Congo red dye tests were all positive and potassium permanganate staining of 1 case was positive. The kidney tissue of 1 case had deposi- tion SAA. One case was diagnosed as secondary AA renal amyloidosis , the other cases were diagnosed as primary AL renal amyloidosis. Conclusions Patients with multiple organ damage, clinical manifestations of nephrotic syn- drome and hormone ineffective, elevated blood pressure, not prominent hematuria should consider whether the patient should be diagnosed as amyloidosis, and renal biopsy and pathology and specific staining is necessary, and then avail- able treatment shoud be received as soon as possible.
出处
《国际泌尿系统杂志》
2015年第3期353-356,共4页
International Journal of Urology and Nephrology
关键词
前列腺增生
膀胱
经尿道前列腺切除术
Prostatic Hyperplasia
Urinary Bladder
Transurethral Resection of Prostate
