经尿道前列腺剜除术联合下腹部小切口治疗112例大体积前列腺增生症  

Clinical study of 112 cases of large benign prostatic hyperplasia treated by transurethal enucleation of prostate combined with extraction gland from small incision on the hypogastrium

作　　者：吴文元[1] 金铁雄[1] 

机构地区：[1]延吉,延边大学附属医院泌尿外科,133000

出　　处：《中国综合临床》2011年第11期1195-1197,共3页Clinical Medicine of China

摘　　要：目的探讨经尿道前列腺剜除术联合下腹部小切口治疗大体积前列腺增生症的可行性、安全性和有效性。方法对112例大体积前列腺增生症患者采用经尿道前列腺剜除术将增生腺体分割成2～3块剜除并推入膀胱后，追加下腹小切口取出腺体的改良式手术方法。结果本组手术时间60～120min，平均（70±lo）rain；术中出血量60～400ml，平均（150±15）m1。术中术后无一例严重的手术并发症。术后3个月最大尿流率（Qmax）由（7．5±2．4）ml／s升至（16．0±2．5）ml／s，残余尿量（RUV）由（75±15）ml降至（25±10）ml，国际前列腺症状评分（IPSS）由（25．5-I-4．5）分降至（8．4±1．3）分，生活质量评分（QOL）由（5．5±0．4）分降至（1．2±0．3）分。与术前比较差异均有统计学意义（t值分别为28．53、36．19、37．16、59．53，P均〈0．05）。随访6个月，无一例永久性尿失禁、尿道狭窄及勃起功能障碍等并发症。结论经尿道前列腺剜除术联合下腹部小切口治疗大体积前列腺增生症，疗效好、安全、可在临床推广。Objective To explore the feasibility, efficent and safety of transuretheral enucleation of prostate combined with extraction of gland pieces from small lower mid-line incision （LMI）. Methods One hundred and twelve patients with large benign prostatic hyperplasia were treated by modified transurethral nucleation of prostate,during the operation, the gland was divided into 2 - 3 parts which were extracted from a small LMI. Results In this method the operation time was 60 - 120 min with an average time of （70 ± 10） rain and blood loss during operation was 60 - 400 ml with an average of （ 150 ＋ 15 ） ml. There was no severe complication during and after operation. At the 3 month after surgery,the urine flow rate（Qmax） increased from （7. 5 ±2. 4） ml/s to （ 16. 0 ± 2. 5 ） ml/s , and urine residual volume （RUV） decreased from （75 ±15 ） ml to （25 ：t： 10） ml, international prostate symptom score （IPSS） decreased from 25. 5 ＋ 4. 5 to 8.4±1.3, and the quality of life （QOL） decreased from 5.5 ±0. 4 to 1.2 ±0. 3. All these changes were statistically significant （t = 28.53,36.19,37.16 and 59.53, Ps 〈 0.05 ） . At the 6 month, no complications , e. g. , permenant uroclepsia,urethrostenosis or erection disfounction occurred. Conclusion Transurethral enucleation of prostate combined with gland extraction from LMI for large benign prostatic hyperplasia is safe and effective and it isworthy of generalization in clinical practice.

关 键 词：前列腺增生 经尿道前列腺剜除 下腹部小切口 安全性 

分 类 号：R699.8[医药卫生—泌尿科学]