分叶分隔法经尿道等离子双极电切术治疗大体积前列腺增生症  

Application of Divided Lobectomy of Transurethral Plasmakinetic Resection of Prostate for Large Volume Benign Prostatic Hyperplasia

作　　者：韩聪祥[1,2] 李金雨[1,2] 林吓聪[1,2] 胡志[1,2] 于忠英[1,2] 许伟杰[1,2] 朱显钟[1,2] 谢智明[1,2] 李伟[1,2] 

机构地区：[1]解放军第175医院 [2]厦门大学附属东南医院泌尿外科,漳州363000

出　　处：《中国微创外科杂志》2015年第5期425-427,430,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨分叶分隔法经尿道等离子双极电切术（plasmakinetic resection of the prostate,PKRP）治疗大体积前列腺增生（体积〉60 ml）的价值。方法 2008年3月~2013年6月我科对218例大体积前列腺增生采用分叶分隔法PKRP,即先切除5~7点位前列腺中叶、11~1点位前列腺顶叶,建立标记沟。沿顶叶标记沟分别向前列腺侧叶的根部近外科包膜处进行切除至中叶标记沟处,使侧叶前列腺仅余少量带蒂组织与基底相连,再大块切除无血管供应的残留侧叶,最后修整精阜周围腺体。结果分叶分隔法行前列腺切除术均顺利完成,切除前列腺重量（52.4±13.2）g,手术时间（65.0±15.5）min,出血量（103.3±37.7）ml。术后1个月国际前列腺症状评分（14.2±3.4）分,比术前（28.7±3.0）分明显降低（t=46.216,P=0.000）;术后生活质量评分（2.8±0.7）分,比术前（5.3±0.5）分明显降低（t=41.323,P=0.000）;术后最大尿流率（19.3±6.4）ml/s,较术前（6.4±2.3）ml/s明显改善（t=-50.112,P=0.000）。结论采用分叶分隔法PKRP治疗大体积前列腺增生安全,疗效满意,易于掌握。Objective To investigate the method and value of divided lobectomy of transurethral plasmakinetic resection of the prostate for the treatment of large volume （ volume〉60 ml） benign prostate hyperplasia . Methods From March 2008 to June 2013, 218 cases of large volume benign prostate hyperplasia underwent divided lobectomy of transurethral plasmakinetic resection .The prostate middle and parietal lobes at 5-7 and 11-1 o′clock location were resected to make marked channels .Then the lateral lobes of prostate were resected along the border of the surgical capsule of prostate to cut down blood supply of prostate and the residual prostate could be resected without bleeding .Finally the prostate around the seminal hillock was trimed .Retrograde uroflowmetry , IPSS score, and QOL score were mesured postoperatively . Results All the operations were finished successfully .The average weight of resected tissue was （52.4 ±13.2） g, the average operation time was （65.0 ±15.5） min, and the average volume of intraoperative blood loss was （103.3 ±37.7） ml.The preoperative IPSS, QOL score and maxium urinary flow rate were （28.7 ±3.0） points, （5.3 ±0.5） points, and （6.4 ±2.3） ml/s, respectively.The postoperative IPSS, QOL score, and maxium urinary flow rate were （14.2 ±3.4） points, （2.8 ±0.7） points, and （19.3 ±6.4） ml/s, respectively.There were significant differences in IPSS , QOL, and Qmax before and after treatment （P =0.000）. Conclusion Divided lobectomy of transurethral plasmakinetic resection of prostate for the treatment of large volume benign prostate hyperplasia is safe and effective , with advantages of easy performance .

关 键 词：前列腺增生症 经尿道前列腺电切术 经尿道前列腺等离子双极电切术 

分 类 号：R699.8[医药卫生—泌尿科学]