经尿道前列腺汽化剜切术治疗良性前列腺增生症657例报告  

Transurethral vapor enucleation of the prostate for BPH patients(Report of 657cases)

作　　者：徐庆康[1] 段跃[1] 于田强[1] 于永涛[1] 陈峰[1] 洪翔[1] 曹林[1] 

机构地区：[1]武警浙江省总队嘉兴医院泌尿外科,浙江嘉兴314000

出　　处：《临床泌尿外科杂志》2016年第6期505-507,共3页Journal of Clinical Urology

摘　　要：目的：探讨经尿道前列腺汽化剜切术治疗良性前列腺增生症（BPH）的疗效及其安全性。方法：2012年7月～2016年1月对657例BPH患者应用等离子纽扣电极结合环状电极行经尿道前列腺汽化剜切术治疗。观察患者手术时间、切除前列腺组织重量、失血量、尿管留置时间、住院时间、围手术期并发症情况;对患者术前术后国际前列腺症状评分（IPSS）,生活质量指数评分（QOL）,最大尿流率（Qmax）、剩余尿量（RUV）进行了随访评估。结果：本组657例患者均顺利完成手术。患者年龄59～87岁,平均67.3岁。术前超声检查测量前列腺体积36～135ml,平均69.5ml。手术采用硬膜外阻滞麻醉或全麻。手术时间50～145min,平均69min。切除前列腺组织重量（43.4±12.8）g。手术前后血红蛋白浓度分别为（121.4±2.7）g/L和（115.8±3.2）g/L,P〉0.05。术后留置导尿管时间（3.1±l.8）d。术后住院时间（4.6±1.5）d。未发生明显出血及经尿道电切综合征,无患者输血。术后3个月随访IPSS由术前（15.6±6.8）分降至术后（6.7±2.4）分,QOL评分由术前（5.4±0.3）降至术后（1.6±0.6）分,Qmax由术前（5.3±0.4）ml/s提高至术后（16.8±2.7）ml/s,RUV由术前（115.3±36.4）ml减少至术后（14.1±2.3）ml,手术前后比较差异均有统计学意义（P〈0.01）。结论：经尿道前列腺汽化剜切术是一种治疗BPH安全有效的可选择方法。Objective：To investigate the efficacy and safety of the transurethral vapor enucleation and resection of the prostate（TVERP）in BPH patients.Method：From July 2012 to January 2016,657 BPH patients were enrolled to accept TVERP using the plasma button electrode and the loop-shaped electrode.The operation time,weight of resected prostate,blood loss,urinary catheterization time,hospital stay and perioperative complications were investigated.The pre-and post-operative score of IPSS,QOL score,Q maxand RUV were recorded during the follow-up period.Result：TVERP were successfully performed in 657 patients.The patients＇ mean age was67.3（range,59-87）years old.The mean volume of the prostate was 69.5（range,36-135）ml.Epidural or general anesthesia was applied in the operation.The mean operation time was 69（range,50-145）min.The weight of the resected prostate was（43.4±12.8）g.The concentration of the haemoglobin was（121.4±2.7）g/L before the operation,and（115.8±3.2）g/L after the operation（P〈0.05）.The postoperative urinary catheterization time was（3.1±l.8）d.The postoperative hospital stay was（4.6±1.5）d.Neither severe blood loss nor transurethral resection syndrome occurred in these patients.Thus no blood transfusion was performed.Three months after the operation,IPSS decreased from（15.6±6.8）preoperatively to（6.7±2.4）postoperatively（P〈0.01）.Alao,QOL decreased from（5.4±0.3）to（1.6±0.6）.Qmaximproved from（5.3±0.4）ml/s to（16.8±2.7）ml/s and RUV improved significantly from（115.3±36.4）ml to（14.1±2.3）ml.Conclusion：TVERP is effective and safe and could be an alternative surgical option for BPH patients.

关 键 词：良性前列腺增生 经尿道前列腺汽化剜切术 等离子纽扣式电极 前列腺剜除 

分 类 号：R697[医药卫生—泌尿科学]