TURP联合膀胱穿刺造瘘与单独TURP治疗大体积BPH的疗效比较  

Comparison of clinical efficacy of TURP combined with bladder puncture fistulation with TURP in patients with large-valume BPH

作　　者：钟以全 周映平 严峻 李俊芳 ZHONG Yi-quan;Zhou Yingping;YAN Jun;LI Jun-fang(Department of Urology,Shaoshan people's Hospitol,Hunan 411300,P.R.China)

机构地区：[1]湖南省韶山市人民医院,411300

出　　处：《首都食品与医药》2020年第16期15-17,共3页Capital Food Medicine

摘　　要：目的探讨经尿道前列腺电切术(TURP)联合膀胱穿刺造瘘治疗大体积(>80ml)良性前列腺增生症(BPH)的安全性与有效性.方法回顾性总结我院2003年10月~2019年10月85例TURP治疗大体积BPH的临床资料,其中应用单独TURP治疗大体积BPH40例,应用TURP联合膀胱穿刺造瘘治疗大体积BPH45例,比较术前血Na^+、术中膀胱测压、术中出血量、手术时间、切下前列腺组织重量、术后血Na^+、住院时间、术后并发症、术后Qmax、RUV、IPSS、QOL.结果85例患者均手术成功,无中转开放手术者.单独TURP组中,术前血Na^+、术中膀胱测压、术中出血量、手术时间、切下前列腺组织重量、术后血Na^+、住院时间分别是(142.7±3.7)mmol/L、(40±17.3)cmH2O、(170.3±50.9)ml、(105.3±15.6)min、(70.1±1.5)g、(135.3±4.5)mmol/L、(7.0±1.5)d.TURP联合膀胱穿刺造瘘组中,术前血Na^+、术中膀胱测压、术中出血量、手术时间、切下前列腺组织重量、术后血Na^+、住院时间分别是(141.6±4.6)mmol/L、(15±2.3)cmH2O、(133.02±21.7)ml、(89.1±14.2)min、(73.6±1.5)g、(140.2±3.7)mmol/l、(6.0±1.5)d.两组在术中膀胱测压、术中出血量、手术时间、术后血Na^+方面有明显差异(P<0.05),两组在术前血Na^+、切下前列腺组织重量、住院时间方面无明显差异(P>0.05).单独TURP组中输血4例(4/40),占10%,发生电切综合征(TURS)4例(4/40),占10%,术后继发大出血者3例(3/40),占7.5%;TURP联合膀胱穿刺造瘘组中输血1例(1/45),占2.2%,无TURS发生,无术后继发大出血者.两组在输血、TURS、术后继发大出血方面有明显差异(P<0.05),两组术后Qmax、RUV、IPSS、QOL无明显差异(P>0.05).结论对于治疗大体积(>80ml)BPH患者,TURP和TURP联合膀胱穿刺造瘘均有明显的临床疗效,在手术过程及术后并发症方面,TURP联合膀胱穿刺造瘘优于单独TURP,更安全、有效.0bjective To explore the fficacy and safety of the transurethral vaporization resection of prostate(TURP)combined with bladder puncture fistulation in patients with large-valume BPH(volume of prostate>80m).Methods A total of 85 large-valume BPH patients underwent TURP from oct 2003 to oct 2019 in our hospital.The clinical data of 85 patients(TURP 40 cases,TURP combined with bladder puneture fistulation 45 cases)were retrospectively analyzed.The data including preoperative serum sodium,intraoperative bladder pressure,the amount bleeding,operation time,cut prostate tissue weight,postoperative blood sodium,length of stay,postoperative complications,Qmax,RUV,IPSS,QOL postoperatively.were compared between the two groups.Results All procedures were performed successfully without conversion to open surgery.The clinical data of TURP group were as follows:the mean preoperative serum sodium was(142.7±3.7)mmol/L;the mean intraoperative bladder pressure was(40±17.3)cmH20;the mean amount bleeding was(170.3±50.9)ml;the mean operation time was(105.3±15.6)min;the mean cut prostate tissue weight was(70.1±1.5)g;the mean postoperative blood sodium was(135.3±4.5)mmol/L;the mean length of stay was(7.0±1.5)d.The elinical data of TURP combined with bladder puncture fistulation group were as follows:the mean preoperative serum sodium was(141.6±4.6)mmol/L;the mean intraoperative bladder pressure was(15±2.3)cmH2O;the mean amount bleeding was(133.02±21.7)ml;the mean operation time was(89.1±14.2)min;the mean cut prostate tissue weight was(73.6±1.5)g;the mean postoperative blood sodium was(140.2±3.7)mmol/;the mean length of stay was(6.0士1.5)d.There were significant differences in the intraoperative bladder pressure,amount bleeding,operation time,postoperative blood sodium between the two groups(P<0.05)。In the preoperative serum sodium,cut prostate tissue weight,length of stay there were no.significant differences between the two groups(P>0.05).The elinical data of TURP group were:the blood transfusion was 4 cases(4/40)10%,th

关 键 词：良性前列腺增生症 经尿道前列腺电切术 穿刺造瘘手术 

分 类 号：R697.3[医药卫生—泌尿科学]