侧入路4步法经尿道前列腺等离子解剖性剜除术治疗大体积前列腺增生  

Lateral four steps transurethral plasmakinetic enucleation and resection of the prostate for large size benign prostatic hyperplasia

作　　者：张浩[1] 司徒杰[1] 李名钊[1] 方友强[1] 肖恒军[1] 高新[1] 庞俊[1] 

机构地区：[1]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2016年第1期5-7,共3页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金面上项目(81372731)

摘　　要：目的探讨侧入路4步法经尿道前列腺等离子解剖性剜除术治疗大体积前列腺增生的疗效及安全性。方法 2013年1月至2015年5月中山大学附属第三医院泌尿外科采用侧入路4步法经尿道前列腺等离子解剖性剜除术治疗体积〉80 ml的前列腺增生患者90例,记录术中出血量,切除腺体体积,手术时间,对比术前术后残余尿量,最大尿流率。结果 90例均顺利完成手术。术中出血量30-120 ml,平均（56±21）ml;手术时间30-100 min,平均（60±23）min;切除腺体50-120 g,平均（69±29）g。与术前经直肠前列腺超声比较,平均切除率68.6%（62.5%-76.3%）。与术前相比,术后3个月患者残余尿量明显减少[（83.4±25.6）ml vs（7.2±2.5）ml,P=0.017],最大尿流率明显增加[（7.4±3.2）ml/s vs（21.3±5.6）ml/s,P=0.019],IPSS评分明显好转[（25.6±4.3）分vs（7.3±3.6）分,P=0.012]。结论侧入路4步法经尿道前列腺等离子解剖性剜除术治疗大体积前列腺增生的疗效确切,并发症少,尤其对于外科包膜的寻找有独到优势,易于掌握,值得临床推广。Objective To study the efficacy of lateral four steps transurethral plasma kinetic enucleation and resection of the prostate for large size benign prostatic hyperplasia（BPH）. Methods Totally90 patients with BPH, who had surgical indications, received lateral four steps transurethral plasmakinetic enucleation and resection of the prostate in the Third Affiliated Hospital of Sun Yet-Sen University from Jan.2013 to May 2015. The blood loss, resection volume of the prostate, operating time were recorded. The perioperative outcome data were compared. Results The operations of total 90 cases were successfully completed. The mean operation time was（60±23） min（range, 30-100 min） with a mean blood loss of（56 ±21） ml（range, 30-120 ml）. The resected prostate weighed 50-120 g（mean, 69±29 g）. By comparing with the preoperative transanal B-ultrasonography, the mean removal rate was 68.6%（62.5%-76.3%）. After the operation, the patients showed significantly less volume of residual urine in 3 months [（83.4 ±25.6） ml vs（7.2±2.5） ml, P=0.017], as well as significantly increased maximum flow rate（Qmax） [（7.4 ±3.2） ml/s vs（21.3±5.6） ml/s, P=0.019] and better international prostate symptom score（IPSS） [（25.6 ±4.3） vs（7.3 ±3.6）,P=0.012]. Conclusion By using lateral four steps transurethral plasmakinetic enucleation and resection of the prostate for large size benign prostatic hyperplasia, it is much easier to learn with a good outcome for patients with BPH.

关 键 词：前列腺增生 前列腺切除术 解剖性 

分 类 号：R699.8[医药卫生—泌尿科学]