经尿道前列腺电切术治疗大体积良性前列腺增生疗效分析

Transurethral resection of prostate for treatment of massive benign prostatic hyperplasia

目的探讨经尿道前列腺电切术（TURP）治疗大体积（〉80g）良性前列腺增生（BPH）的疗效。方法选取大体积BPH患者47例，均采用硬膜外麻醉行经尿道前列腺电切术。观察术中出血情况、手术时间、术后尿管留置时间、排尿情况、最大尿流率及住院时间等。结果47例均顺利完成前列腺电切术。手术时间75～150（101±15）min，无输血病例。术后留置导尿管3～5d，均排尿通畅，无尿失禁，术后住院时间5～7d。术后3个月时，平均最大尿流率由术前（4．3±0．5）ml／s增至（17．2±1．5）ml／S，国际前列腺症状评分及生活质量评分由术前的28．0±5．5和5．04-0．5分别降至8．5±2．3和2．5±0．4，手术前后比较差异均有统计学意义（均P〈0．01）。术后无继发出血。结论TURP治疗大体积BPH是一种安全、有效的微创治疗方法，可显著提高手术效率。

Objective To evaluate the efficacy of transurethral resection of the prostate （TURP） for treatment of massive benign prostatic hyperplasia （BPH）. Methods Forty-seven patients with obstructive massive BPH （〉80g） were treated with TURP. Transfusion rate, resection time, time of indwelling catheter, length of hospital stay, improvement in urinary flow rate （Qmax）, international prostate symptom score （IPSS） and quality of life （QOL） were measured. Results All cases were success- fully operated. The mean operation time was （101 ± 15） rain. There was no transfusion in all patients. The catheter was indwelled for 3 to 5 d postoperatively. All patients were satisfied with voiding outcome, none had incontinence. The length of hospital stay ranged from 5 to 7 d postoperatively. All cases were followed up for 3±42 months. Mean Qmax increased from （4.3 ± 0.5） ml/s preoperatively to （17.2 ± 1.5） ml/s postoperatively. IPSS decreased from 28.0 ± 5.5 to 8.5 ± 2.3 and QL score decreased from 5.0 ± 0.5 to 2.5 ± 0.4, respectively （P〈0.01）. No hemorrhage occurred after the operation. Conclusion TURP for massive BPH is a safe, effective and minimally invasive treatment method.