经尿道等离子体双极电切术治疗良性前列腺增生及膀胱肿瘤  

Transurethral resection of the hyperplastic prostate and bladder tumor using bipolar plasmakinetic technique

作　　者：王行环[1] 王怀鹏[1] 陈浩阳[1] 刘久敏[1] 罗耀雄[1] 冯自卫[1] 罗则民[1] 

机构地区：[1]广东省人民医院泌尿外科,广州510080

出　　处：《中华泌尿外科杂志》2003年第5期318-320,共3页Chinese Journal of Urology

摘　　要：目的　探讨经尿道等离子体双极电切的安全性与有效性。　方法　用经尿道等离子体双极电切行前列腺切除 (PKRP) 30 0例 ,前列腺 2 1～ 12 6 g ,平均 (49.7± 35 .8) g ;行浅表性膀胱肿瘤切除 (PKRBT) 37例 ,肿瘤分级G12 5例 ,G2 12例。术后随访 1～ 6个月。　结果　PKRP手术时间 13～ 98min ,平均 (48± 31)min ;切除前列腺组织重量 7～ 91g ,平均 (31± 2 9)g。无 1例需输血 ,无电切综合征发生。术后 1、3、6个月 ,最大尿流率 (Qmax)由术前的 (5 .2± 3.9)ml/s分别上升至 (19.2±4 .1)、(2 1.8± 4 .6 )、(2 2 .3± 5 .7)ml/s;国际前列腺症状评分 (IPSS)由术前的 2 4 .7下降至 5 .7、5 .4、5 .1;生活质量评分 (QOL)由术前的 5 .3分别下降至 1.7、1.8、1.2。 3项指标手术前后比较差异均有显著性意义 (P <0 .0 5 )。PKRBT手术时间 5～ 39min ,平均 (2 4± 13)min。 17例侧壁肿瘤切除时 ,5例发生闭孔神经反射 ,其中 1例发生膀胱穿孔。随访 1～ 6个月无复发。　结论　用等离子体双极电切进行PKRP和PKRBT安全有效。Objective To assess the efficacy and safety of transurethral resection of the prostate(PKRP) and bladder tumor(PKRBT) with plasmakinetic energy. Methods 300 patients(mean age of 71.6 years;range from 52 to 91) with symptomatic BPH without suspected cancer (confirmed by IPSS,urinary flow rate,ultrasonographic estimate and PSA tests) were treated by PKRP. 37 patients with superficial transitional cell carcinoma (17 with tumors appearing at the lateral wall) were treated by PKRBT.All patients were followed up for 1～6 months postoperatively. Results For PKRP,the duration of the procedure was (48±31) min(range 13 to 98 min).No case need blood transfusion during the operation.No transurethral resection syndrom occurred.The mean catheterization time was 2 days (1 to 4 days). The peak flow rate increased from (5.2±3.9) to (19.2±4.1),(21.8±4.6),(22.3±5.7)ml/s at 1,3 and 6 months respectively. The IPSS decreased from 24.7 to 5.7, 5.4,5.0 and the QOL decreased from 5.3 to 1.7,1.8,1.2 at 1,3 and 6 months respectively.For PKRBT,the duration of the procedure was (24±13) min(range 5 to 39 min) with little bleeding.The adductor reflex was found in 5 of the 17 cases with tumor located at the lateral wall. Conclusions It is suggested that transurethral bipolar plasmakinetic resection of the prostate and bladder tumor is effective and safe. This pilot series permits a comparative study with conventional TUR system.

关 键 词：前列腺增生 膀胱肿瘤 经尿道等离子体双极电切术 前列腺切除术 膀胱肿瘤切除术 

分 类 号：R699[医药卫生—泌尿科学]