摘要
目的:探讨经尿道前列腺汽化剜除术治疗前列腺增生的有效性和安全性。方法:2015年5月~2017年1月,应用Olympus纽扣式等离子电极结合组织粉碎器对57例前列腺增生患者进行经尿道前列腺剜除术与组织粉碎术。观察本组病例手术时间、组织粉碎器使用时间、术后血红蛋白浓度降低情况、切除前列腺组织重量、术后接受膀胱冲洗时间、尿管留置时间以及围手术期并发症等情况。比较患者术前及术后6个月时国际前列腺症状评分(IPSS)、最大尿流率(Q_(max))、剩余尿量(PVR)以及生活质量评分(QOL)。结果:57例患者手术时间65~178 min,平均(83.6±29.2)min。术后血红蛋白浓度降低0.1~2.7 g/L,平均(1.3±0.2)g/L。切除前列腺组织重量35~67 g,平均(43.8±12.4)g。术后接受膀胱冲洗时间11~58 h,平均(26.2±11.6)h、尿管留置时间3~8 d,平均(4.5±1.4)d。术后6个月随访,IPSS评分、Q_(max)、PVR以及QOL评分均较术前明显改善(P<0.01)。2例患者使用组织粉碎器过程中出现膀胱黏膜损伤,术中予以电凝止血,术后适当延长导尿管留置时间。1例患者术后出现短暂的压力性尿失禁,术后6周恢复。围手术期无严重并发症发生。结论:经尿道前列腺纽扣式等离子电极汽化剜除术结合组织粉碎器治疗前列腺增生,是一种安全有效的手术方法。
Objective: To discuss the efficiency and safety of transurethral vapor enucleation of prostate with TURis button electrode. Methods: During May 2015 to January 2017,57 patients were given transurethral vapor enucleation of prostate with TURis button electrode plus tissue morcellator in our hospital. The operation time,time of tissue morcellator, the decline of hemoglobin concentration, the weight of resected tissue, time of irrigation, catheterization period and perioperative complications were recorded. The changes of IPSS, QOL, Q_(max), and PVR were compared before and 6 months after operation. Results: All the 57 patients received general anesthesia.The mean operative duration was(83.6±29. 2) min(65-178 min),the mean decline of hemoglobin concentration was(1. 3±0. 2) g/L(0.1-2. 7 g/L),the mean weight of resected tissue was(43. 8±12. 4) g(35-67 g),the mean irrigating duration was(26. 2±11. 6) h(11-58 h),and the mean catheterization period was(4. 5±1. 4) days(3-8 days). Six months after the operation, the IPSS, Q_(max), QOL and PVR were improved significantly as compared with those before operation. The mucosal bladder injury occurred in 2 patients, and treated accordingly. Shortterm incontinence occurred in one patient,and recovered 6 weeks after operation. No sever complication was observed. Conclusions: Transurethral vapor enucleation of prostate with TURis button electrode plus tissue morcellator is a safe and effective method in the treatment of benign prostatic hyperplasia.
出处
《微创泌尿外科杂志》
2017年第6期364-367,共4页
Journal of Minimally Invasive Urology
