经尿道前列腺汽化电切术治疗前列腺增生症1820例

Transurethral electrovaporization of the prostate for benign prostatic hyperplasia in reports of 1820 cases

目的：探讨经尿道前列腺汽化电切术治疗前列腺增生症的优越性及减少并发症发生的有效方法。方法：对1820例前列腺增生症采用经尿道前列腺汽化电切术治疗。结果：1820例前列腺增生症患者中，856例术后获随访1～7年，平均18．5个月。国际前列腺症状积分由术前29．1±2．7下降至10．4±2．1；生活质量评分由5．2±0．7降至1．7±0．3；残余尿量由（150．3±52．0）mL减少至（21．3±12．3）mL。最大尿流率由（6．8±1．1）mL／s增加至（34．2±3．5）mL／s，平均尿流率由（4．3±0．8）mL／s增大至（10．2±1．5）mL／s。上述指标术前术后相比有显著性差异（P〈0．05）。术后发生并发症59例，其中经尿道电切综合征3例；术中出血较多15例；尿失禁1例；术后迟发性出血16例；改行开放性手术12例；尿道狭窄8例；尿路感染4例。结论：经尿道前列腺汽化电切术是现行治疗前列腺增生症的最有效方法，操作的熟练程度是减少并发症的有效保证。

Objective To study the cause, prophylaxis and treatment of the complications due to transurethral electrovaporization of the prostate. Methods Transurethral electrovaporization of the prostate was performed in 1820 patients with benign prostatic hyperplasia. Results Of these 1820 cases, 856 cases were followed up for 1 to 7 years after operation. International Prostatic Symptom Score was decreased from 29.1±2. 7 to 10.4±2. 1, QOL from 5. 2±0. 7 to 1. 7±0. 3, UR from （150.3±52.0） mL to （21.3±12.3） mL, Qmax increased from （6.8±1.1） to （34.2±3.5） mL/s, average flow-rate from （4.3±0. 8） to （10.2±1, 5） mL/s. There was significant difference before and after operation（P±0.05）. Various severe complications occurred in 59 cases, TURS in 3 cases, over bleeding in 15 cases, urine incontinence in 1 cases, sluggish bleeding in 16 cases, opening operation in 12 cases, urethra straitness in 8 cases, ure-infection cases in 4 cases. Conclusion Transurethral electrovaporization of the prostate is the most effective way to treat benign prostatic hyperplasia. The skilled operation can reduce various complications.