耻骨上膀胱穿刺造瘘联合双极等离子电切术治疗大体积前列腺的临床研究  

Clinical Study on Cystostomy in Transurethral Plasma Kinetic Resection of Prostate in the Treatment of Large-Volume Prostate

作　　者：尤志新[1] 张浩宇 屈维龙[1] 张肖翔[1] 徐赟峰 李亦磊 汪益民[1] YOU Zhi-xin;ZHANG Hao-yu;QU Wei-long;ZHANG Xiao-xiang;XU Yun-feng;LI Yi-lei;WANG Yi-ming(Department of Urological Surgery,Kunshan Second People's Hospital,Kunshan,Jiangsu,215300,China)

机构地区：[1]江苏省昆山市第二人民医院泌尿外科,江苏昆山215300

出　　处：《中国血液流变学杂志》2021年第2期213-215,233,共4页Chinese Journal of Hemorheology

基　　金：昆山市社会发展科技专项(KS18083)。

摘　　要：目的探讨膀胱造瘘在经尿道前列腺双极等离子电切术(TKRP)治疗大体积前列腺增生中的价值。方法收集2018年10月—2021年3月,前列腺体积(PV)大于80 mL的前列腺增生患者82例,均行TKRP治疗,其中术前行膀胱造瘘41例为试验组,常规手术41例为对照组,评估比较两组患者的手术时间、血红蛋白下降水平、切除的前列腺质量、术后膀胱冲洗时间、术后住院天数、术后前列腺症状评分(IPSS)、最大尿流率(Qmax)及术后远期并发症的差异。结果与对照组相比,试验组手术时间短,血红蛋白下降水平小,切除的前列腺质量多,术后膀胱冲洗时间及术后住院时间短,差异有统计学意义(P<0.05)。两组术后3个月随访结果均提示IPSS较术前明显降低,Qmax较术前明显提高,而两组间比较差异无统计学意义(P>0.05)。两组术后均未出现远期并发症。结论术前膀胱造瘘联合TKRP术是外科治疗大体积前列腺较为理想的手术方式。Objective To explore the value of cystostomy in transurethral plasma kinetic resection of prostate(TKRP)in the treatment of large-volume benign prostatic hyperplasia.Methods From October 2018 to March 2021,82 cases of prostate hyperplasia patients with prostate volume(PV)greater than 80 mL were treated with TKRP.Among them,41 cases underwent cystostomy before TKRP in the experimental group,and 41 cases underwent TKRP only in the control group.The difference in the operation time,hemoglobin reduction level,the quality of the removed prostate,the postoperative bladder irrigation time,the postoperative hospital stay,the postoperative international prostate symptom score(IPSS),the maximum urinary flow rate(Qmax)and the longterm postoperative complications between the two groups were evaluated and compared.Results Compared with the control group,the experimental group had shorter operation time,lower hemoglobin reduction level,higher quality of the prostate removed,shorter postoperative bladder irrigation time and postoperative hospital stay,the difference was statistically significant(P<0.05).The three-month follow-up results of the two groups showed that IPSS was significantly lower than that before operation,and Qmax was significantly higher than that before operation,but there was no statistically significant difference between the two groups(P>0.05).No long-term complications occurred in the two groups.Conclusion TKRP combined with preoperative bladder fistula is an ideal surgical method for surgical treatment of large-volume prostate.

关 键 词：经尿道前列腺双极等离子电切术 大体积前列腺增生 膀胱造瘘 

分 类 号：R697.32[医药卫生—泌尿科学]