经尿道等离子双极电切术治疗大体积良性前列腺增生诊疗体会

Transurethral bipolar plasmakinetic resection of the prostate in patients with large-volume benign prostatic hyperplasia

目的：探讨经尿道等离子双极电切术（PKRP）治疗大体积良性前列腺增生（BPH）的疗效及安全性，并总结手术经验。方法：收集20082011年间39例在我院采用PKRP治疗的前列腺体积〉80ml的BPH患者的临床资料，分析手术时间、术中出血量、手术并发症以及手术前后最大尿流率（Qmax）、剩余尿量（RUV）、国际前列腺症状评分（IPSS）以及生活质量评分（QOL）情况。结果：39例患者均一次手术成功，手术时间（98．1±17．6）min，术中出血（133．4±21．8）ml。1例患者因术中失血量较多行输血治疗，2例患者术后发生尿路感染，1例患者发生暂时性尿失禁，无电切综合症发生，无死亡病例。Qmax、RUV、IPSS及QOL评分较术前明显改善（P〈0．05）。结论：在做好围手术期准备、术者经验丰富的情况下，采用PKRP治疗〉80ml的BPH患者仍然安全有效。

Objective： To explore the curative effects and safety of the transurethral bipolar plasmakinetic re- section （PKRP） of the prostate in patients with large-volume benign prostatic hyperplasia （BPH） and summarize the experience of the surgeries. Method： A total of 39 BPH patients with prostate larger than 80 ml underwent PKRP from 2008 to 2011. Clinical data including operative time, intraoperative blood loss, the complications of operation and International Prostate Symptom Score （IPSS）, quality of life （QOL） score, maximum urinary flow rate （Q max）, residual urine volume （RUV） were analyzed. Result： All the patients were operated successfully with an average operation time of （98.1±17. 6） minutes. Intraoperative blood loss was （133.4±21.8） ml. A- mong these patients, one case experienced blood transfusion after operation and two cases suffered from urinary in- fection. One case experienced temporary urinary incontinence. No TURS or death occurred after the operation. There were significant differences of IPSS, Q RUV and QOL between preoperative data and postoperative six months data （ P 〈0.05）. Conclusion： PKRP is a safe and effective therapy for BPH patients with prostate volume larger than 80 ml under the condition of careful management in the perioperative period and skillful techniques.