经尿道汽化结合电切术治疗良性前列腺增生症

The treatment of benign prostatic hyperplasia by transurethral vaporization combined with resection

目的 探讨经尿道汽化结合电切术治疗良性前列腺增生症 (Benignprostatehyperplasia ,BPH)的临床疗效及并发症的防治。 方法 低位硬膜外麻醉下 ,联合使用环状电极、滚筒状电极以及铲状电极对 83例BPH行经尿道汽化结合电切术。 结果 平均手术时间 5 8min ,平均失血量 80ml,均未输血 ,无经尿道电切综合征 (Transurethalresectionsyndrome ,TURS)发生。全部病例随访 2月～ 2年 ,国际前列腺症状评分 (IPSS)由术前 (2 6 4± 5 7)分下降至术后 (8 4± 3 9)分 (t =2 0 31,P <0 0 0 1) ,生活质量(QOL)评分由术前 (4 9± 0 4 )分下降至术后 (1 6± 0 3)分 (t=3 92 ,P <0 0 0 1) ,最大尿流率 (Maximumflowrate ,MFR)由术前 (5 1± 3 7)ml s上升至术后 (16 3± 4 2 )ml s(t=5 6 4 ,P <0 0 0 1)。 结论 经尿道前列腺汽化术 (Transurethalvaporizationofprostate ,TVP)结合经尿道前列腺电切术 (Transurethalresectionofprostate ,TURP)治疗BPH安全性高、并发症少、效果确切。

Objective To explore the clinical efficacy of transurethral vaporization combined with resection in the treatment of benign prostatic hyperplasia(BPH) and prevention of complications. Methods Under low position continuous epidural anesthesia, 83 cases of BPH were treated by transurethral vaporization and resection with Stabilized loop, roller-shape and spade electrodes. Results The mean operative time was 58 min and blood loss 80ml. No blood transfusion was required and no transurethral resection syndrome(TURS) occurred. All patients had been followed up for 2 months～2 years. IPSS decreased from(26 4±5 7)points to(8 4±3 9) points( t =20 31, P <0 001); QOL decreased from(4 9±0 4) points to (1 6±0 3) points( t =3 92, P <0 001); Maximum flow rate(MFR) increased from (5 1±3 7)ml/s to(16 3±4 2)ml/s ( t =5 64, P <0 001). Conclusions The results suggest that TVP combined with TURP has the advantages of high safety, less complications and definite efficacy in the treatment of BPH.