经尿道等离子前列腺电切术中不同切除方法的应用(附1900例报告)

Application of Various Methods of Transurethral Plasmakinetic Resection of Prostate(Report of 1900 Cases)

目的:探讨经尿道等离子前列腺电切术(PKRP)治疗BPH的方法和疗效。方法:在PKRP中根据前列腺大小及其与包膜粘连情况等分别采用单纯顺行电切法、分割顺行电切法、分割逆行切除法、完全逆行切除法治疗BPH患者1 900例,并比较其疗效。结果:1 900例手术顺利,术中无电切综合征、直肠穿孔、膀胱穿孔发生;术后发生短期尿失禁83例,继发出血1例,尿道狭窄54例,膀胱颈挛缩4例,增生复发3例,术后住院期间死亡1例。术后6个月随访,国际前列腺症状评分、生活质量评分、最大尿流率均较术前明显改善(P<0.01)。结论:采用PKRP治疗BPH安全有效,根据腺体大小及其与包膜粘连情况等采用不同方法进行电切,可拓宽前列腺电切适应证,降低并发症。

Objective：To evaluate the surgical effects and methods of transurethral plasmakinetic resection of prostate （PKRP） for treatment of benign prostatic hyperplastia （BPH）. Methods：According to the volume of the hyperplastic prostate and whether the prostate adhesion with capsule or not, the 1 900 patients were performed anterograde resection, partition anterograde resection, partition retrograde enucleation or completely retrograde enueleation, and their efficacy compared. Results：Of the 1900 cases underwent the procedure uneventfully. There were no transurethral resection syndrome, intestinal perforation, bladder perforation. After surgery, 83 cases had short term urinary incontinence, 1 case secondary bleeding, 54 cases urethral stricture, 4 cases bladder neck contracture, 3 cases recurrence of BPH. 1 case had died during the hospital stay. After the follow-up of 6 months, there was significant difference of IPSS, QOL, Qmax before and after treatment （P〈0. 01）. Conclusions： It is suggested that PKRP is effective and safe. It can widen clinical indications and decrease surgical complications by vari- ous methods of transurethral reseetion of prostate.