经尿道双极等离子电汽化治疗前列腺增生症45例报告  

Transurethral Resection of the Hyperplastic Prostate Using Bipolar Plasmakinetic Electrovaporization Technique

作　　者：沃飞[1] 李世文[1] 

机构地区：[1]武汉大学中南医院泌尿外科,武汉430071

出　　处：《武汉大学学报（医学版）》2005年第5期665-667,669,共4页Medical Journal of Wuhan University

摘　　要：目的:探讨经尿道双极等离子电汽化(PKRP) 治疗前列腺增生症的有效性及安全性. 方法:采用英国Gyrus经尿道双极等离子汽化电切镜系统治疗前列腺增生症(BPH) 45例. 年龄57～83岁,平均70岁,前列腺重量20～151 g,平均(53.9±28.5) g;均有手术适应证,术后随访1～6月.结果:PKRP手术时间(55±25) min(25～100 min),切除前列腺组织重量(31±7) g (20～50 g),术后2～6 d拔除导尿管,术中有1例需要输血(800 ml), 无TUR综合征发生,术后2例尿道外口狭窄,经尿道扩张2周后尿线变粗,1例暂时性尿失禁者进行提肛锻炼,随访1个月后恢复.术后最大尿流率(Qmax)由术前的(9.4±3.9)ml·s-1升至(19.2±3) ml·s-1,国际前列腺症状评分(IPSS)由术前的25.2下降至5.4,生活质量评分(QOL)由术前的5.1下降至1.1.该项指标手术前后比较均有显著改善.结论:用等离子体双极电切进行经尿道前列腺切除是一种安全、 有效的手术方式.Objective： To assess the efficacy and safety of transurethral resection of the prostate with bipolar plasmakinetic （PKRP） in the treatment of benign prostatic hyperplasia （BPH）. Methods： 45 patients with symptomatic BPH were treated with bipolar plasmakinetic electro-vaporization with saline irrigation. International prostate symptom score （IPSS） with a quality of life （QOL） scoring questionnaire, uroflowmetry （maximum flow rate; Qmax）, residual urine volume and prostate specific antigen （PSA） measurements had been performed before surgery. All patients were followed up for 1～6 months postoperatively. Results： The mean operative time was （55±25） rain （range from 25 to 100 min）, the mean weight of the resected tissue was （31±7） g （range from 20 to 50 g）, one case needed blood transfusion during the operation （800 ml）, and no transurethral resection syndrome occurred. The mean catheterization time was 4 days （2～6 d）. Urethral stricture occurred in 2 cases postoperation, and was treated by urethral dilatation for 2 weeks. The Qmax increased from （9.4±3. 9） to （19.2±3） ml·s^-1 , the IPSS decreased from 25.2 to 5.4, and the QOL decreased from 5.1 to 1.1 after 6 months. Postoperative values of IPSS, QOL and Qmax showed significant improvement compared with preoperative values （P〈0.05）. Conclusion： Transurethral bipolar plasmakinetic resection of the prostate is an effective and safe method with fewer complications. It is recommended for the treatment of BPH.

关 键 词：良性前列腺增生症 经尿道 双极等离子电汽化 

分 类 号：R697.32[医药卫生—泌尿科学]