经尿道等离子体双极汽化电切术治疗高危前列腺增生（附72例报告）

Transurethral plasmakinetic electrovaporization therapy for high risk patients with benign prostate hyperplasia （report of 72 cases ）

目的 探讨经尿道等离子体双极电切术（TUBVP）治疗高危前列腺增生症（BPH）的疗效和安全性。方法总结2004年3月至2008年1月采用TUBVP治疗BPH患者72例的临床资料，观察术中情况、术后并发症及疗效。结果72例均手术成功，手术时间36—82min，平均48min，切除前列腺组织重量48—106g，其中38例〉60g。术中失血60—100ml，平均70ml。术后1周发生尿路刺激症状17例，无电切综合征、出血、肠瘘及尿失禁等并发症发生。随访4～6个月，17例尿路刺激症状均减轻或消失，72例中最大尿流率术后平均18．5ml／s；国际前列腺症状评分降至（6．7±1．4）分；生活质量评分降至（1．8±0．4）分。结论TUBVP治疗BPH手术彻底、出血少、尿失禁发生率低，易于操作，临床应用安全、有效。

Objective To evaluate the safety and efficacy of transurethral bipolar plasmakinetic electrovaporization （TUBVP） for the treatment of high risk patients with benign prostate hyperplasia. Methods The clinical experiences of transurethral plasmakinetic electrovaporization（TUBVP） treatment in 72 cases of benign prostate hyperplasia during Mar 2004 to Jan 2008 were analyzed. Information in operation and postoperative complications and curative effect were observed. Results Total of 72 patients underwent TUBVP safely. The operating time was from 36 to 82 minutes, averaged 48 min. The specimen weight was 48 - 106 g, with more than 60 g in 38 cases. The mean blood loss was 70 ml （60 - 100 ml）. Urinary tract irritation symptom were found in 17 patients with 1 week postoperatively. No postoperative complications such as transurethral resection syndrome, bleeding, intestinal fistula and urinary incontinence occurred. With follow up of 4 - 6 months, all patients had fluent urination. Average Maximal flow rate （Qmax） was 18.5 ml/s. The International Prostate Symptom Scores（IPSS） were decreased to 6.7 ± 1.4. Quality of Life（QOL） decreased to 1.8 ±0.4. Conclusions With high effectiveness, safety, short hospital stay and less＇complications, TUBVP is a safe and effective therapy to high risk patients with benign prostate hyperplasia.