经尿道前列腺电切术/汽化切除术治疗良性前列腺增生5346例临床分析

Clinical analysis of transurethral resection of prostate and transurethral electrovaporization of prostate: a retrospective study of 5346 cases

目的总结经尿道前列腺手术的疗效和常见并发症。方法回顾我院1985年5月至2006年12月经尿道前列腺手术5346例。其中,电切术(TURP)2133例,汽化切除(TVP)+TURP3213例。以1998年1月为界,将经尿道前列腺手术的患者分为早期组(1642例)和近期组(3704例)。将近期组再分为TURP组(1265例)和TVP+TURP组(2439例)。分析患者围手术期指标和随访资料。结果近期组与远期组相比,围手术期指标逐渐优化。近期组中,TURP组和TVP+TURP组的围手术指标和随访指标无显著差异。结论两种手术疗效均满意。TURP仍是手术治疗良性前列腺增生(BPH)的"金标准"。术中以精阜为平面均匀切除腺体,密切观察颈静脉充盈情况和血糖变化,术后定期随访,尽早发现并发症,是成功治疗良性前列腺增生,改善患者生活质量的关键。

Objective To summarize the experience of transurethral resection of prostate（TURP） and transurethral electrovaporization of prostate（TUVP）. Methods A retrospective study was conducted in 5346 consecutive patients who underwent surgery for benign prostatic hyperplasia （BPH） in our institute from May 1985 to December 2006. Patients were separated into early group and recent group by the date of Jan. 1998. The recent group were further separated into TURP group and TURP＋TUVP group. Results Operative skills and perioperative parameters were greatly improved. Over time efficacy and complications are not statistically different between TURP and TURP＋TUVE Conclusion Both TURP and TUVP are efficacious in management of BPH. TURP removes the adenoma rapidly and provides fine resection in apex of prostate, which remains the gold standard in surgical intervention of BPH. Resection with the mark of seminal colliculus, close observation of jugular vein dilatation and blood sugar change intraoperatively, together with regular follow up postoperatively are necessary in management of surgery related complications.