水刀辅助经尿道前列腺剜除术的初步应用及技术探讨  

Preliminary study of hydro-knife assisted transurethral enucleation of prostate

作　　者：屈卫星[1] 周建成[1] 李晶[1] 程永毅[1] 丁上书 Qu Weixing;Zhou Jiancheng;Li Jing;Cheng Yongyi;Ding Shangshu(Department of Urology,the People′s Hospital of Shaanxi Province,Xi′an 710068,China)

机构地区：[1]陕西省人民医院泌尿外科,西安710068

出　　处：《国际泌尿系统杂志》2024年第2期243-247,共5页International Journal of Urology and Nephrology

基　　金：陕西省重点研发计划-社会发展领域(2022SF-465);陕西省人民医院科技人才支持计划(2021BJ-05)。

摘　　要：目的探讨水刀辅助下经尿道前列腺剜除术在良性前列腺增生治疗中的安全性及可行性。方法选取2010年10月至2021年1月于本院实施水刀辅助经尿道前列腺剜除术的28例有手术适应证的老年男性良性前列腺增生患者,分别于术后1、3、6个月进行随访观察,分析患者的手术疗效和并发症情况。结果28例患者均在硬膜外麻醉下实施手术,所有手术均顺利实施,围手术期未发生因水刀设备引起的并发症;平均手术时间58.2(31~112)min;平均留置尿管时间为4.2(3~7)d;术后平均住院时间4.8(4~8)d;平均前列腺切除质量56.3(15.2~92.7)g。围手术期未发生严重并发症,无输血及电解质紊乱发生。术后随访1、3个月内无创面出血、尿道狭窄及二次手术实施发生;术后6个月随访,患者的术后国际前列腺症状评分(IPSS)评分较术前下降,最大尿流率(Qmax)较术前上升,Qmax时逼尿肌压力较术前降低,PV较术前下降(均P<0.05);所有病例无尿失禁发生。结论水刀辅助经尿道前列腺剜除术在临床应用中是可行且安全的,其利用高压水的层面剥离作用,能较完整地去除前列腺腺体,可明显改善下尿路症状。Objective To investigate the safety and feasibility of hydro-knife assisted transurethral enucleation of prostate in benign prostatic hyperplasia.Methods A total of 28 elderly male patients with benign prostatic hyperplasia(BPH)with surgical indications who underwent hydro-knife assisted tranthral prostate enucleation in our hospital from October 2010 to January 2021 were selected for follow-up observation at 1 month,3 and 6 months after surgery,respectively.The surgical efficacy and complications of the patients were analyzed.Results All the 28 patients were operated under epidural anesthesia.All the operations were carried out smoothly,and no complications caused by water knife equipment occurred during perioperative period.The average operation time was 58.2(31-112)min.The mean duration of catheter indwelling was 4.2(3-7)days.The average length of postoperative hospitalization was 4.8(4-8)days.The mean mass of prostatectomy was 56.3(15.2-92.7)g.There were no serious complications,blood transfusion and electrolyte disturbance in perioperative period.No wound bleeding,urethral stricture or secondary operation occurred in 1 or 3 months after follow-up.After 6 months of follow-up,International Prostatic Symptom Score(IPSS)score decreased,maximum urine flow rate(Qmax)increased,the mean detrusor pressure decreased,and PV decreased(P<0.001).No urinary incontinence occurred in all cases.There were no serious complications,blood transfusion and electrolyte disturbance in perioperative period.No wound bleeding,urethral stricture or secondary operation occurred in 1 or 3 months after follow-up.After 6 months of follow-up,IPSS score decreased,Qmax increased,the mean detrusor pressure decreased,and PV decreased(P<0.05).No urinary incontinence occurred in all cases.Conclusions The preliminary study of hydro-knife assisted transurethral enucleation of the prostate shows that its clinical application is feasible and safe.Using the layer stripping effect of high-pressure water can achieve complete removal of prostate glands an

关 键 词：前列腺增生 经尿道前列腺切除术 水刀 

分 类 号：R699.8[医药卫生—泌尿科学]