经尿道四步法等离子前列腺剜除术120例报告

Four-step Method for Transurethral Plasmakinetic Resection of the Prostate: a Report of 120 Cases

目的探讨经尿道四步法等离子前列腺剜除术的疗效。方法我院2012年1月～2014年2月对120例良性前列腺增生行经尿道引、剜、切、修四步法等离子前列腺剜除术。结果手术时间（91.4±35.3）min;术中出血（78.8±34.1）ml;切除前列腺组织重量（32.1±15.7）g;术后膀胱冲洗时间（1.5±0.5）d;术后拔尿管时间（3.5±0.8）d;术后住院（5.5±0.5）d。无死亡、输血和前列腺电切综合征发生。术后3个月随访：术后IPSS（4.5±2.2）分,明显小于术前（24.5±5.1）分（t=39.445,P=0.000）;术后最大尿流率（21.5±10.5）ml/s,明显大于术前（6.0±1.9）ml/s（t=15.912,P=0.000）;术后残余尿（12.0±2.0）ml,明显少于术前（145.0±33.0）ml（t=44.069,P=0.000）。术后未发生逆行射精、性功能障碍和排尿困难等并发症。结论经尿道四步法等离子前列腺剜除术具有切除前列腺彻底,手术安全,简便易学等诸多优点。

Objective To explore the efficacy of four-step method for transurethral enucleation of the prostate. Methods A retrospective analysis was conducted on 120 cases of benign prostate hyperplasia （BPH） treated with four-step method （traetion, enucleation, resection, and repair） for transurethral plasmakinetie resection of the prostate in our hospital from January 2012 to February 2014. Results The average operation time was （91.4 ± 35.3） min. The intraoperative blood loss was 78.8 ±34.1 ml. The resection of the prostate tissue weight was （32.1± 15.7） g. The postoperative bladder infusion time was （1.5 ± 0.5 ） days. The postoperative indwelling catheter time was 3.5 ± 0.8 days. The postoperative hospital stay was （5.5 ± 0. 5） days. No death, blood transfusion, or TURS happened. Follow-up reviews at 3 months after surgery found postoperative international prostatic symptom score （IPSS） was significantly less than the preoperative level [ 4.5 ± 2.2 vs. 24.5 ± 5. 1, t = 39. 445, P = 0. 000 ], postoperative Qmax was significantly higher than preoperative level [（21. 5 ± 10. 5） ml/s vs. （6. 0 ± 1. 9） ml/s, t = 15. 912, P =0.000], and postoperative residual urine was significantly less than the preoperative level [ （ 12.0 ± 2. 0） ml vs. （ 145.0 ± 33.0） ml; t = 44. 069, P = 0. 000 ]. No retrograde ejaculation, sexual dysfunction, or dysuria happened. Conclusion The four-step method for transurethral enucleation of the prostate is radical, safe, and simple.