经尿道改良“三明治”气化切割法治疗超大前列腺增生症(附120例报告)

Reformed “Sandwich" of Transurethral Vapor-resection in the Treatment of Super-volume Benign Prostatic Hyperplasia

目的 探讨经尿道改良的“三明治”气化切割法治疗超大前列腺增生症的效果。方法 对 12 0例前列腺重量超过 75g的超大BPH实施经尿道改良的“三明治”气化切割术 ,在手术的不同阶段交替应用气化切割圈、纵槽状气化电极、电切襻 ;前列腺重量 75～ 2 17g ,手术时间 6 5～ 180min ,出血量 30～ 2 0 0ml,留置导尿管时间 3～ 6天。结果 最大尿流率由术前的 (7.1± 2 .4 )ml/s上升至术后 3个月的 (17.4± 2 .6 )ml/s,国际前列腺症状评分由术前的 2 6 .6± 2 .8降至术后 3个月的 6 .4± 2 .4 (P <0 .0 1)。结论 经尿道改良的前列腺“三明治”气化切割术是集经尿道前列腺电切术 (TURP)和经尿道前列腺电气化术 (TUVP)之所长 。

Objective\ To study the effect of reformed “sandwich' of transurethral vapor resection in the treatment of super volume benign prostatic hyperplasia.Methods\ Reformed “sandwich' of transurethral vapor resection was used to treat 120 cases of super volume BPH. Vapor Tome、Vapor Trode、Cutting Loop were used alternately during the operation. The weight of the prostate was 75～217 grams; the time of operation was 65～180 minutes; the interoperation bleeding was 30～200 milliliters and the catheterization time lasted 3～6 days. Results\ Qmax increased from( 7.1±2.4 ) ml/s preopreatively to (17.4± 2.6) ml/s 3 months after operation and IPSS decreased from 26.6±2.8 preopreatively to 6.4±2.4(P< 0.01) 3 months after operation. Conclusion \ Reformed sandwich of transurethral vapor resection has the advantages of both TURP and TUVP. Besides, it is safe and effective with fewer complications. The vapor resection is an ideal treatment for super volume BPH.