经尿道前列腺电切术1370例手术体会

Clinic experience of 1370 patients with transurethral resection of prostate

目的总结1370例经尿道前列腺电切术经验，提高手术疗效。方法回顾性分析1998年7月至2012年3月期间我院收治1370例BPH患者行TURP术的临床资料。年龄58～99岁，平均（67．4±5．5）岁。前列腺体积21～85ml，平均（53±4．4）ml。详细记录手术时间、术中出血量、术后留置尿管时间及手术并发症，统计并分析手术前后国际前列腺症状评分（IPSS）、生活质量评分（QOL）及残余尿量（Ruv）等指标。结果1370例患者中，成功施行TURP术1367例，中转开放手术3例。手术时间25～93min，平均（52．0±6．4）min。术中出血量30～800ml，平均（120．0±8．8）ml，输血12例。术后留置尿管2～9d，平均（4．5±1．1）d。术后随访3个月，IPSS、QOL及RUV与术前比较有统计学差异。术中水中毒1例，术后迟发性出血18例，暂时性尿失禁11例，尿道狭窄26例。结论TURP术具有创伤小、疗效好，安全有效，并发症少等的优点，充分的围手术期准备是手术顺利实施和减少并发症的重要保证，值得临床推广。

Objective To summerize the clinical experiences of 1370 cases who underwent transurethral resection of the prostate. Methods A retrospective study of 1370 patients with benign prostatic hyperplasia（BPH） who underwent TURP from July 1998 to March 2012 were analyzed. Mean age was （67.4±5.5, 58-99 years）, mean prostate volume was （53±4.4, 21-85 ml）. Operation time, intraoperative blood loss, postoperative time of inurethral catheter and complications were detailedly recorded. The （international prostate symptom score, IPSS）, quality of life score （QOL） and residual urine volurne（RUV） before and after surgery had been statistically analyzed. Results TURP were performed successfully in 1367 cases, The other 3 cases were converted to open surgery. Mean Operation time was （52.0±6.4, 25-93 rain）, mean intraoperative blood loss volume was （120.0±8.8, 30-800 ml）, 12 cases required blood transfusion. Mean postoperative time of inurethral catheter was （4.5±1.1, 2-9 days）. After 3-month follow-up, IPSS, QOL and RUV before operation were compared with post operation that had significant differences （P〈0.05）. The complication of intraoperative water poisoning, postoperative delayed hemorrhages, urethral stricture and incontinence occurred in 1 case, 18 cases, 26 cases and 11 cases, respectively. Conclusions Sufficient perioperative preparation is important for operation. TURP is worth expanding for patients with BPH because of minimal invasion, efficacy and safty.