膀胱穿刺造瘘辅助行经尿道双极等离子前列腺电切术的临床观察

Effect of combined percutaneous puncture cystostomy and transurethral bipolar plasmakinetic prostatectomyon treating benign prostatic hyperplasia with urethral stricture

目的探讨膀胱造瘘辅助行经尿道双极等离子前列腺电切术治疗合并尿道狭窄的前列腺增生的效果。方法回顾性研究2011年5月~2016年4月本院诊治的438例前列腺增生症患者,其中有412例患者行经传统的尿道双极等离子前列腺电切术,26例合并尿道狭窄患者中。26例合并有尿道狭窄中19例采用膀胱穿刺造瘘辅助下经尿道双极等离子前列腺电切除治疗除,另7例由于严重尿道狭窄未实施手术治疗。将19例采用膀胱穿刺造瘘辅助下前列腺电切患者作为观察对象,另选择19例传统经尿道前列腺电切患者作为对照组,分析两组手术效果。结果观察组患者电切手术时间110.34±10.46 min,术中出血量80.34±6.12 m L,二者均高于传统的经尿道电切术,两组间差异有统计学意义。两组在切除前列腺组织、术后冲洗膀胱时间、术后膀胱残余尿量、前列腺症状评分方面的差异均没有统计学意义。结论经尿道等离子前列腺电切术联合膀胱穿刺造瘘术治疗合并尿道狭窄的前列腺增生患者的手术时间及术中出血量有所增加,但手术总体效果良好,并发症没有增加。

Objective To explore the effect of percutaneous puncture cystostomy and transure-thral bipolar plasmakinetic prostatectomyintreatingbenign prostatic hyperplasia combining urethralstricture. Methods A retrospective study 438 cases of benign prostatic hyperplasia patients from May2011 to April 2016 in our hospital was performed,in which 412 cases underwent transurethral bipolarplasmakinetic resection of prostate,19 cases with urethral stenosis underwent cystostomy and transure-thral prostatic resection treatment(observation group,n=19),7 cases with severe urethral stricture weretreated by the other approach. Of 412 cases undergoing transurethral bipolar plasmakinetic resection ofprostate,19 cases were selected as control group(n=19). The effect of two group were recorded.Results The observation group showed longer operation time(110.34+10.46 min)and more blood lossduring operation(80.34+6.12 ml)than control group(all P values less than 0.05). No serious complica-tionoccurred in two group. Conclusion For the patients combining benign prostatic hyperplasia andurethral stricture,percutaneous puncture cystostomy-assistant transurethral bipolar plasmakinetic prosta-tectomy was an effective and safe surgical procedure but the time of operation and the amount of bleedingduring operation were increased.