耻骨上小通道腺体粉碎辅助治疗巨大前列腺增生的临床研究  

Gland Morcellation via Assisted Suprapubical Small Channel for Giant Prostatic Hyperplasia

作　　者：胡志雄[1] 杨帝宽 吴保忠[1] 刘明建[1] 车晓娟[1] 肖剑[1] 

机构地区：[1]广东省肇庆市第二人民医院泌尿外科,肇庆市526060

出　　处：《微创医学》2015年第2期149-151,154,共4页Journal of Minimally Invasive Medicine

摘　　要：目的探讨经尿道前列腺完全性剜除辅助耻骨上小通道膀胱内腺体粉碎治疗巨大前列腺增生的疗效及安全性。方法经术前估算前列腺体积大于150mL的前列腺增生患者23例，前列腺体积153～263mL，平均（176±22）mL，均采用经尿道前列腺完全性剜除辅助耻骨上小通道膀胱内腺体粉碎的术式，比较术前、术后血红蛋白、肾功能、电解质、血气分析等数据变化，并统计电切综合征、下肢深静脉血栓、输血及迟发性出血的发生率。结果23例患者均手术成功，手术时间86～126min，平均（97±13）min，切除腺体87～168g，平均（118±15）g；术后血红蛋白、Na＋、BE均降低，PaO2升高，差异有统计学意义（P〈0．05），BUN、Cr、K＋、Cl-、血pH值、PaCO2的差异无统计学意义（P〉0．05）。发生电切综合征1例，未发生下肢深静脉血栓，无输血病例，拔除尿管后均排尿通畅。结论应用经尿道前列腺完全性剜除辅助耻骨上小通道膀胱内腺体粉碎的术式治疗巨大前列腺增生安全有效，为巨大前列腺增生的治疗提供了新的方法。Objective To evaluate the value and safety of entiretransurethral enucleation combined with morcellation of the gland via assisted suprapubical small channel for giant prostatic hyperplasia. Methods The volume of the prostate of 23 patients suffered benign prostatic hyperplasia were more than 150 ml preoperative,ranging frome 153 to 263 ml, averaging 176 ±22ml. All of them were treated by entire transurethral enucleation combined with morcellation of the gland via suprapubical small channel. The data of hemoglobin, function of kidney, electrolyte, blood gas analysis before and after the operation were compared. Transfusion, TRU syndrome or deep venous thrombosis were also analyzed. Results All patients were successfully treated, The time of operation was 86 ± 126 min, with the average of 97± 13 rain. The mean weight of resected gland was 118 ±15g, ranging from 87 g to 168 g. The value of hemoglobin, Na＋ , BE decreased, and PaO2 were all significantly increased （P 〈0.05）. BUN,Cr, K＋ ,Cl- ,Ph and PaCO2 showed no differences （ P 〉 0. 05 ）. TRU syndrome occurred in one case. Neither transfusion nor deep venous thrombosis occurred. No acute urinary retention happened after catheter was removed. Conclusions It is safe and practical to undergo transurethral enucleation combined with morcellation of the gland via assisted suprapubical small channel for giant prostatic hyperplasia. It is a new way of operation for giant prostatic hyperplasia.

关 键 词：巨大前列腺增生 经尿道前列腺剜除 辅助耻骨上小通道 前列腺粉碎 安全性 

分 类 号：R699.8[医药卫生—泌尿科学]