巨大体积前列腺增生的开放性外科治疗  

Open surgical management of huge benign prostatic hyperplasia

作　　者：张一川[1] 何乐业[1] 龙智[1] 黄凯[1] 孙晓辉[1] 彭东毅[1] 岳栋[1] 钟狂飚[1] 

机构地区：[1]中南大学湘雅三医院泌尿外科,长沙410013

出　　处：《中国男科学杂志》2011年第8期32-35,共4页Chinese Journal of Andrology

摘　　要：目的探讨巨大前列腺增生的外科治疗方法选择及临床处理经验。方法回顾性分析10例巨大前列腺增生的患者的临床资料，患者平均年龄70．5岁，平均前列腺体积225ml，术前平均最大尿流率（Qmax）为4．6ml／s，平均国际前列腺症状评分（IPSS）27分，平均生活质量指数（QoL）5分。结果10例患者均采用耻骨上经膀胱前列腺摘除术，摘除腺体平均重213g，平均手术时间85min，术中平均出血550ml，2例输血1～2u。术后连续膀胱冲洗平均2d，留置导尿管平均13d，留置膀胱造口管平均14d，术后平均住院时间15d。所有患者安全度过围手术期，拔管（导尿管及膀胱造口管）后能自行排尿，2例出现轻度尿失禁。出院时Qmax平均18．5ml／s，IPSS评分平均7．5分，QoL评分平均1．5分。结论开放性耻骨上经膀胱前列腺摘除术是治疗巨大前列腺增生的一种安全有效的方法，围手术期的充分准备是减少术后并发症、保证患者安全的有力措施。Objective To investigate the surgical management options and clinical treatment experience of huge benign prostatic hyperplasia. Methods Clinical data of 10 cases with huge benign prostatic hyperplasia were analyzed retrospectively. Average age of all patients was 70.5 years old, mean prostate volume was 225ml, preoperative mean maximum flow rate （Qmax） was 4.6ml/s, the average international prostate symptom score （IPSS） score was 27 points and average quality of life （QOL） was 5 points. Results All 10 patients were treated by suprapubic prostatectomy, the average weight of removed gland was 213g, mean operative time was 85 min, intraoperative mean blood loss was 550ml and 1 to 2 units of blood transfusion was received by two patients. Postoperative continuous bladder irrigation lasted for 2 days on average, indwelling catheter for average 13 days, indwelling cystostomy tube for average 14 days and mean postoperative hospital stay was 15 days. All patients were safe through the perioperative period and voided without difficulty after extubation （catheter and cystostomy tubes）, but 2 patients had mild urinary incontinence. Average Qmax was 18.5ml/ s at discharge, average IPSS score was 7.5 with average QoL 1.5 points. Conclusion Open suprapubic prostatectomy is a safe and effective way for the treatment of huge benign prostatic hyperplasia. Careful preparation is a safe and effective way to reduce postoperative complications and ensure patient safety during perioperative period.

关 键 词：前列腺增生/外科学 

分 类 号：R697.32[医药卫生—泌尿科学]