结扎膀胱下动脉耻骨上前列腺切除术治疗高危前列腺增生症35例  

Suprapubic prostatectomy with ligating inferior vesica artery in the treatment of the high risks of BPH patients:Report of 35 cases

作　　者：钟玉蛟[1] 连小明[1] 李兴法[1] 

机构地区：[1]惠安县医院泌尿外科,362100

出　　处：《福建医药杂志》2004年第6期30-31,共2页Fujian Medical Journal

摘　　要：目的　为探讨高危前列腺增生前列腺切除术止血方式。方法　采用结扎膀胱下动脉耻骨上前列腺切除术治疗高危前列腺增生 35例。结果　本组 35例病人 ,手术时间 1 5～ 2小时 ,平均 1 5小时 ;切除前列腺重量为 30～ 12 0g ,平均 4 5g ;均经病理证实为前列腺增生。术中出血 80～ 2 5 0ml,平均 10 3ml;输血 0～ 4 0 0ml,平均 6 0ml;有 2 6例未输血。 9例术后返回病房后尿液变清 ,2 6例术后 2～ 3天尿液转清 ,停止膀胱持续点滴冲洗。 9～ 14天拔除尿管、膀胱造瘘管。随访 2～ 9年 ,排尿恢复良好 ,无明显并发症。与术前比较 ,IPSS评分由术前平均 2 8 4分降至 9 5分 ;QOL评分由 4 5分降至 2 0 5分 ;Qmax由 5 4ml/s上升至 18 5ml/s;残余尿 (RUV)由 180ml降至 15ml。经统计学处理 ,IPSS评分、QOL、Qmax和RUV术前术后比较差异有极显著意义 (P <0 0 1)。结论　采用结扎膀胱下动脉耻骨上前列腺切除术治疗高危前列腺增生症出血少 ,安全有效。Objective To investigate prevention of hemorrhage during suprapubic prostatectomy for the high risks of BPH patients.Method The clinical condition and surgical risks of 35 cases of BPH patients were treated by using application of ligating inferior vesica artery during suprapubic prostatectomy.Results Operation coure time 90～120 minutes,average 90 minutes,average resection organization 45 gramme.The hemorrhage amount was obviously reduced.Voiding function recovered very well.The patients have been follewed up for two to nine years with satisfactory result,the mean IPSS score and QOL score evidently decreased,and the Q max scores obviously increased and the RUV significantly decreased.Conclusion Application of ligating inferior vesical artery during suprapubic prostatectomy for the high risks of BPH patients was little bleeding in the operation and it was safe and effect.

关 键 词：动脉结扎 膀胱下动脉 耻骨上前列腺切除术 高危前列腺增生症 

分 类 号：R699[医药卫生—泌尿科学]