经尿道前列腺汽化电切术并发症的临床分析

Clinical Analysis of the Complications in the Transurethral Electro-vaporization of Prostate

目的探讨经尿道前列腺汽化电切术术中、术后常见并发症及其产生原因,总结防治经验,提高TUVP的治疗效果。方法回顾369例前列腺增生症患者TUVP资料,对术中及术后并发症的发生原因及处理方法进行分析,随访3～12个月。结果本组无死亡病例,电切综合征2例,术中大出血8例,术后出血填塞膀胱4例,术后继发性出血4例,暂时性尿失禁5例,术后排尿困难3例,尿道狭窄11例,尿路感染10例,睾丸附睾炎2例,阳痿8例,逆行射精16例,下肢深静脉血栓形成1例。结论TUVP是目前治疗BPH的一种安全、有效、使用较广泛的微创技术,减少TUVP的并发症的发生关键在于预防,术前要严格掌握手术的适应证,积极治疗合并症,术中要有熟练的手术操作基本功,保持清晰的视野,确切止血,术后合理有效控制尿路感染,可提高手术的安全性和治疗效果,减少TUVP术后并发症的发生。

Objective To study the reasons of the transurethral electro-vaporization of prostate（TUVP） intraoperative and postoperative complications ,summarize the control experience, to improve the therapeutic effect of TUVP. Methods The data of 369 patients with benign prostatic hyperplasis （BPH）were reviewed,to analysis the cause and disposal methods of intraoperative and postoperative complications, the follow up was 3-12 months. Results No patient died,TURS 2 cases,burst bleeding in operation 8 cases,postoperative hemorrhage lead to bladder packing 4 cases,postoperation bleeding 4 cases ,Temporary incon-tinence 5 cases ,postoperative dysuria 3 cases, urethral stricture 11 cases,urinary tract infection 10 cases,orchiepididymitis 2 cases,impotence 8 cases,retrograde ejaculation 16 cases,lower extremity deep venous thrombosis 1 case. Conclusion TUVP is a safe and effective,widely used minimally invasive technique for the treatment of BPH at present. The key reduce the incidence of TUVP complications is the prevention,palmar grasp the adaption of operation strictly,effective treatment of complication,skillful manipulation of embolization in intraoperative,keeping the view clearly,exact hemostasis,reasonable effective control urinary tract infection after operation, can improve security and efficacy in operation, reduces the happening of TUVP complication.