经尿道前列腺汽化电切术中电切深度标识的探讨  

A discussion on signs of a proper depth of ablation during transurethral electrovaporization of the prostate

作　　者：刘威[1] 钟鸿烈[1] 陈静[1] 李永刚[1] 潘斌[1] 陈东[1] 赵旭[1] 

机构地区：[1]鞍钢铁西医院泌尿外科,鞍山114012

出　　处：《中国微创外科杂志》2005年第7期572-573,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经尿道前列腺汽化电切术(transurethral electrovaporization of the prostate,TUVP)电切深度标识的可行性. 方法回顾性分析616例前列腺增生症临床资料,其中310例术前彩超提示合并前列腺钙化,156例合并膀胱结石,23例合并膀胱肿瘤.TUVP操作过程中,观察到合并前列腺结石和机械操作'打滑现象',停止电切. 结果全组手术时间30～120 min,平均75 min.术中验证术前彩超提示合并前列腺钙化的310例前列腺钙化为结石,同时发现其余306例均存在结石.1例术中膀胱穿孔,无尿道直肠瘘和尿道电切综合征发生.325例随访3～6个月,平均4.5月,最大尿流率由6.5～8.5 ml/s提高到18～22 ml/s,残余尿由70～150 ml降至0～10 ml,国际前列腺症状评分由19～24.5分降至0～7分.138例膀胱结石和23例膀胱肿瘤无复发. 结论前列腺结石和机械操作'打滑现象'作为TUVP的电切深度标识是切实可行的.Objective To discuss the utilization of signs of a proper depth of ablation during transurethral electrovaporization of the prostate (TUVP). Methods A retrospective analysis was made on clinical records of 616 cases of benign prostatic hyperplasia (BPH). Preoperative color ultrasonography revealed a co-morbidity of prostatic calcification in 310 cases. A total of 156 cases also had vesical calculi and 23 cases complicated tumors of the bladder. On the performance of TUVP, once a co-morbidity of prostatic calculus or a “slipping phenomenon” during mechanical operation was observed, the ablation was stopped. Results The operative time was 30~120 min (mean, 75 min). During the surgery, preoperatively diagnosed prostatic calcification in the 310 cases was confirmed as prostatic calculus, and in the remaining 306 cases prostatic calculus was also found. Vesical perforation occurred during the surgery in 1 case. No urethrorectal fistula or transurethral resection of the prostate syndrome happened. Follow-up observations were conducted for 3~6 months (mean, 4.5 months) in 325 cases. The maximal flow rate (Qmax) was elevated from 6.5~8.5 ml/s to 8~22 ml/s. The residual urine volume (RU) decreased from 70~150 ml to 0~10 ml, and the International Prostate Symptom Scores (I-PSS), from 19~24.5 to 0~7. Of 138 cases of vesical calculus and 23 cases of bladder tumor, no recurrence was noted. Conclusions Prostatic calculus and the “slipping phenomenon” indicate a proper depth of ablation during transurethral electrovaporization of the prostate.

关 键 词：前列腺结石 打滑现象 标识 电切深度 

分 类 号：R699[医药卫生—泌尿科学]