经尿道等离子双极电切术治疗高危巨大前列腺增生症50例分析

Analysis of transurethral plasmakinetic resection of prostate for high risk huge benign prostate hyperplasia(Reports of 50 cases)

目的探讨经尿道等离子双极电切术(TUPKRP)治疗高危巨大良性前列腺增生症(BPH)的临床疗效及安全性。方法 2003年12月—2010年12月,在我院采用TUPKRP治疗的高危巨大BPH患者共50例,观察其平均手术时间、术中出血量、手术并发症、术后住院天数,记录并计算手术前后的国际前列腺症状评分(IPSS)、残余尿量及尿流率改变等指标的差异。结果 50例均安全渡过围术期,平均手术时间(97±42)min,术中出血量(210±75)ml,切除前列腺质量(140±47)g,IPSS由术前平均31.5±4.6下降至9.4±2.4,最大尿流率由术前(4.5±1.3)ml/s增加至术后(14.6±5.1)ml/s,残余尿量由术前(200.4±52.7)ml下降至术后(32.5±13.5)ml,手术前后比较差异均有统计学意义(P<0.05)。结论应用TUPKRP治疗高危巨大BPH,疗效确切,完善的围术期处理是确保安全性的重要保证。

Objective To evaluate the clinical effect and security of transurethral plasmakinetic resection of prostate （TUPKRP） for high risk huge benign proslate hyperplasia （BPH）. Methods 50 cases of high risk huge BPH accepted TUPKRP from December 2003 to December 2010 in our hospital. Operation time, blood loss, complications, postoperative hospital stay, international prostate symptom score （IPSS）, residual urine volume, uroflowmetry were recorded and calculated. Results All of the 50 cases passed perioperative period safely. Average operation time was （97 ± 42） min, blood loss was （210 ± 75 ） ml, weight of pre-excision was （ 140 ± 47 ） g, IPSS decreased from （ 31.5 _± d. 6 ） to （9.4 ± 2.4 ）, maximum urine flow rate increased from （ 4.5 ± 1.3 ） ml/s to （ 14.6 ± 5.1 ） ml/s, residual urine volume decreased from （ 200.4 _± 52.7 ） ml to （ 32.5 -± 13.5 ） ml. There were significant statistical difference between pre-operation and post-operation （ P 〈 0.05 ）. Conclusion TUPKRP is effective and safe on high risk huge BPH. Careful perioperative controlling is very important to ensure the safety of patients.