经尿道等离子体前列腺切除的临床应用

The clinical value of transurethral bipolar plasmakinetic prostatectomy

目的 评价经尿道双极等离子体前列腺切除（TUPKP）的安全性和有效性。方法 86例良性前列腺增生（BPH）患者，年龄52-85岁，平均70岁。采用等离子体切割技术行经尿道前列腺切除，切割方法采用Alcock或Flocks法。术后随访3个月至1年，比较术后最大尿流率（Qmax）和IPSS评分恢复情况。结果 手术时间30-150分钟，切割获取前列腺组织平均55g，平均出血150ml。术后持续膀胱冲洗时间0．5-1天，留置导尿管时间3-5天，平均住院时间6天。术后3个月Qmax平均恢复至每秒24．5ml，IPSS评分自平均24分降至6分。结论 初步结果显示，TUPKP治疗前列腺增生症是安全可靠的，与经尿道膀胱肿瘤电切术（TURP）比较，具有安全性高、适应证广、出血少、损伤小、恢复快等优点。

Objective To assess the efficacy and the safety of transurethral bipolar plasmakinetie prostateetomy （TUPKP）. Methods Eighty-six patients （mean age 70; range 52 -85 years） with benign prostatic hyperplasia（BPH） underwent TUPKP. The methods of the operation were Aleock or Flocks. After operation, the patients were followed up at 3 months to 1 year and measured the International Prostate Symptom Score （IPSS） and maximum urinary flow rate. Results The operative time was 30 minutes to 150 minutes. The average weight of the prostate tissue cut of in the operation was 55g. The average blood loss was 150 ml. The time of postoperative continuous bladder irrigation was 0. 5 day to 1 day. The catheterization time was 3 days to 5 days. The average postoperative hospital stay was 6 days. The mean peak flow rate in- creased at least 24.5 ml/s and the IPSS decreased from 24 to 6 at 3 months. Conclusion The preliminary results with TUPKP suggest that it is a useful and safe endoscopic device. It appears to be an effective treatment for BPH. This pilot series permits a comparative study with TURP to assess the benefits for patients and the health care system.