三种术式治疗前列腺增生症的比较与选择(附1848例报告)

Comparative Study and Select of Three Operative Mode to Cure BPH

目的:探讨耻骨上经膀胱前列腺摘除术(TVP)、耻骨后保留尿道前列腺摘除术(Madigan术)、经尿道前列腺汽化电切术(TUVP)治疗前列腺增生症(BPH)适应症及临床疗效。方法:TVP 757例,Madigan术579例,TUVP512例。结果:TVP组、Madigan术组、TUVP组输血者分别为423例(56%)、232例(40%)、66例(13.1%)平均输血量分别为280mL、108mL、45mL。住院天数分别为16.9d、14.5d、9.5d。术后并发症分别为45例(7.7%)、20例(3.5%)、20例(3.9%)。结论:TVP手术操作容易掌握,能完全切除增生的前列腺组织,并能同时处理膀胱内病变,手术效果好,并发症较多。Madigan术、TUVP手术对患者损伤小,痛苦少,恢复快,适应症较宽。TUVP手术需要特殊器械。

Objective： To investigate adaptive indications and clinical curative effect of suprapubic pros- tatectomy（ TVP） , proctatectomy with preservation of urethra（ Madigan ） and transurethral electrovaprization ablation of prostste （TUVP）. Methods： TVP 757 cases, Madigan 579 cases and TUVP 512 cases. Result： Blood transfusion difference were 423 cases {56% ） in TVP , 232 cases {40% ） in Madigan and 66 cases （ 13.1% ） in TUVP . The average quantity of blood transfusion were 280ml, 108ml and 45ml. Patients who were in hospital were 16.9days, 14.5days and 9.5days. The complications in groups were 45 cases （7. 7% ） ,20 cases {3.5% ） and 20 cases （3.9%） postoperative respectively. Conclusion： The operationis eas- ier in TVP, excision prostate hyperplasia tissue entirely. At the same time, to treat urinary bladder patholog- ical changes easily . The method had better effect, and more complications. Madigan and TUVP are consid- ered as a therapeutic modality with the advantages of less trauma, less painful, rapid recovery . TUVP need specialties medical appliance.