经尿道等离子汽化电极前列腺剜除治疗良性前列腺增生（附56例报告）  

Evaluation of bipolar transurethral enucleation and resection of the prostate in treatment of benign prostatic hyperplasia using TURis plasma vaporization electrode with 56 case reports

作　　者：乔庐东[1] 陈山[1] 张光银 刘跃新[1] 郑宇朋[1] 王伟[1] 

机构地区：[1]首都医科大学附属北京同仁医院泌尿外科,北京100730

出　　处：《中国男科学杂志》2012年第9期49-52,共4页Chinese Journal of Andrology

摘　　要：目的评估采用经尿道TURis蘑菇型等离子双极汽化电极前列腺剜除治疗前列腺增生患者的有效性和安全性。方法自2011年10月至2012年3月，连续56名前列腺增生（BPH）引起下尿路症状的患者，使用OlympusTURis蘑菇型等离子双极汽化电极，分中叶、两侧叶自精阜沿前列腺包膜剜除，治疗终点是完全切除前列腺组织至包膜以形成足够的前列腺腔道。结果56例BPH患者年龄54～85岁（平均68．2岁），患者术前前列腺体积为46～163ml，平均（75．3±36．4）ml，术前血红蛋白（13．2±1．2）g／L，血清Na^＋（134．2±9．2）mmol／L，术前Qmax（6．2±2．2）ml／s，IPSS（22．7±7．8）分，QoL（4．3±1．2）分，残余尿（132．54±114．6）ml。所有患者均经尿道完成手术，没有中转开放病例，手术时间40～118min，平均（60．6±38．3）min，术后监测血红蛋白（12．94±2．3）g／L（与术前相比P〈0．05），但无需输血病例，术后血清Na^＋（132．24±3．4）mmol／L（与术前相比P〉0．05）。术后3个月患者IPSS（5．7±2．3）、OoL（2．1±0．3），Qmax（16．2±6．2），残余尿（23．4±16．3）ml，各项指标与术前比较均明显改善（P值均〈0．05）。结论经尿道蘑菇型等离子双极汽化电极具有全方位切割、充分的止血，穿透深度浅等特点，使用该电极行经尿道前列腺剜除技术可以有效治疗BPH患者的下尿路症状，具有良好的安全性和临床疗效。Objective To investigate the efficacy and safety of transurethral enucleation and resection of the prostate in the treatment of benign prostatic hyperplasia using TURis plasma vaporization electrode. Methods In total 56 patients with symptomatic benign prostatic hyperplasia who had underwent transurethral enucleation and resection of prostatic adenoma using TURis plasma vaporization electrode from Oct. 2011 to Mar. 2012 were enrolled in the study. The seminal colliculus was first identified as a reference plane, then the prostate was enucleated with TRUS plasma vaporization electrode and finally the prostate tissues were removed on the surface of surgical capsula to form a sufficient cavity. Results The 56 patients were successfully operated on. No operation was converted to open surgery. All patients had significant improvement in subjective symptoms and urodynamic parameters. The mean preoperative prostate volume was （75.3±36.4）ml, the mean IPSS was （22.7±7.8）, QOL was （4.34±1.2）, and Qmax （6.2±2.2）ml/s. The mean operative time was （60.6±38.3）minutes. The serum sodium did not change, while the serum hemoglobin level reduced slightly, but no blood transfusion was needed. Three months later, the mean IPSS was （5.7±2.3） and QOL was （2.1±0.3）. Qmax was （16.2±6.2）ml/s and residual urine was （23.4±16.3）ml. Complications including external meatus stricture were found in 2 patients during 3-6 months following-up. Conclusion Transurethral enucleation and resection of the prostate using TURis plasma vaporization electrode has better efficacy and minimal bleeding, which has become a good option in the treatment of benign prostatic adenoma.

关 键 词：前列腺增生 经尿道前列腺切除术 

分 类 号：R697.32[医药卫生—泌尿科学]