经尿道前列腺等离子电切术常见并发症及处理对策

Common complications and treatment countermeasures in transurethral plasmakinetic prostatectomy

目的探讨经尿道前列腺等离子电切术治疗良性前列腺增生的术中及术后常见并发症,提出处理对策、加速患者康复。方法回顾性总结2004年6月至2015年6月1606例经尿道前列腺等离子电切术患者的临床资料,分析术中及术后出现的并发症。结果 1596例患者均顺利完成手术并取得良好效果,7例中转开放手术(2例膀胱穿刺进入腹腔,2例自发性膀胱破裂,3例切割过深引起冲洗液外渗),3例被迫中断手术(3例手术器械故障致组织切割不断)。其中73例术后有不同程度的并发症,包括膀胱痉挛46例,膀胱填塞重返手术5例,精神症状改变10例,术后3日持续出血12例。结论经尿道前列腺等离子电切术是治疗良性前列腺增生的成熟术式,疗效确切,但术中及术后有一定的并发症,需要积极处理。

Objective To explore intraoperative and postoperative common complications in transurethral plasmakinetic prostatectomy in the treatment of benign prostate hyperplasia,and put forward treatment countermeasures for accelerating patient rehabilitation.Methods Clinical data were retrospectively summarized in 1606 patients with transurethral plasmakinetic prostatectomy from June 2004 to June 2015.The intraoperative and postoperative common complications were analyzed.Results A total of 1596 patients successfully completed surgery and achieved good results.But 7 cases were transmitted open surgery（2 cases of bladder puncture into the abdominal cavity,2 cases of spontaneous bladder rupture,3 cases of cutting too deep cause rinses extravasation）,and 3 cases were forced to interrupt the operation（tissue can’t be cut off because of surgical instrument malfunction）.Among them,there were different level postoperative complications in 73 cases,including 46 cases of bladder spasm,5 cases of bladder filling back surgery,10 cases of mental symptoms change,12 cases of postoperative bleeding for 3day.Conclusion Transurethral plasmakinetic prostatectomy is the mature operation and curative effect,but there is a certain intraoperative and postoperative complication which needs aggressive treatment.