1例TURP术中TURPS的麻醉处理

前列腺增生肥大是老年男性的常见病、多发病．排尿困难、夜尿增多影响生活质量。手术切除是目前的主要治疗手段。但多数患者年老体弱，常合并心肺等重要脏器的病变，对麻醉和手术的耐受力下降。近几年经尿道前列腺切除术（TURP）由于不需开刀、创伤小、恢复快、并发症少和安全性大的优点而易被病人接受。TURPS（经尿道前列腺电切术综合征，TURP综合征）虽很少出现，但应被引起熏视，一旦发现要及时处理。

TURP术后谵妄危险因素的Meta分析

目的:系统评价前列腺患者经尿道电切术后发生谵妄的危险因素,为临床决策提供参考。方法:通过PubMed、Embase、The Cochrane Library、Web of Science、CNKI、万方数据库、维普数据库、CBM等数据库检索关于经尿道前列腺电切术后谵妄危险因素的相关文献。检索时限均为建库至2023年3月31日。按照纳入与排除标准对获得的文献独立进行文献筛选、资料提取,采用NOS量表进行质量评价,采用Review Manager 5.3软件进行Meta分析。结果:本研究共纳入689篇文献,共4495例患者,术后发生谵妄的患者为309例,发生率为6.87%。Meta分析结果显示:年龄[OR = 2.64, 95% CI (1.35~5.17), P = 0.06]、基础疾病[OR = 4.57, 95% CI (3.09~6.78), P P = 0.03]、缺氧[OR = 3.33, 95% CI (2.15~5.20), P = 0.003]、电解质紊乱[OR = 7.71, 95% CI (5.71~10.41), P = 0.09]、睡眠障碍[OR = 5.50, 95% CI (3.49~9.63), P = 0.07]是TURP后发生谵妄的危险因素。结论:现有证据表明,年龄、基础疾病、术后膀胱痉挛、电解质紊乱、缺氧、睡眠障碍是患者术后发生谵妄的危险因素,在临床实践中,医务人员应重视这些危险因素,对TURP术后患者需加强观察,做到早评估、早干预、早治疗,减轻患者认知功能损害,提高老年人生活质量,但受到文献质量的限制,研究结果的真实性亟待更多高质量研究来进行进一步验证。

TURP综合征的诊治及预防

TURP综合征是机体吸收膨宫液体而导致的稀释性低钠血症,继而引发的一系列症状,是宫腔镜手术中发生的一种少见并发症。可出现心率快、血压高等早期症状,严重者导致肺水肿、心衰竭、脑水肿甚至死亡。如诊治不及时,其后果往往比较严重,及时并且适度的纠正电解质紊乱是治疗TURP综合征最主要的方法。临床上常常采用控制膨宫压力、控制手术时间、减少血窦开放、观察液体出入量、避免子宫穿孔等方式来预防TURP综合征,有效降低了TURP综合征的发生率。本文将结合有关文献,对TURP综合征的病因及发病机制、临床表现及分度标准、治疗及预防等几方面进行论述。加强对安全的认识,可降低此并发症的发生率。

Transurethral Resection of the Prostate (TRUP) for the Treatment of Benign Prostatic Hyperplasia (BPH) in Central Cote D’Ivoire: Indications and Results

Background: Benign prostatic hyperplasia (BPH) is defined histologically as adenomyofromatous hyperplasia of the transitional zone of the prostate. It remains the most common benign tumour in men over the age of 50, and transurethral resection of the prostate (TURP) remains the surgical treatment of choice. Objectives: To determine the indications and present our results of transurethral resection of the prostate. Patients and Methods: After obtaining approval from the ethics committee of the private hospital and the university hospital of Bouaké (Côte d’Ivoire), we conducted a cross-sectional study of transurethral resection of the prostate (TURP) to treat benign prostatic hyperplasia (BPH) between January 2021 and April 2023. All patients and their families were informed beforehand and had signed an informed consent form. All patients with benign prostatic hyperplasia (BPH) with ultrasound weight of less than 80 grams were included. The following parameters were studied: age, reason for consultation, ultrasound prostate weight of benign prostatic hyperplasia, indication for TURP, duration of operation, blood loss, duration of post-PRT urinary drainage, length of hospital stay, morbidity and mortality, and outcome. Results: 39 patients with a mean age of 58.3 years (57-77 years) underwent transurethral resection of the prostate (TURP). TURP was indicated in 46.15% (n = 18) of cases of refractory acute urinary retention with failure of the urinary catheter removal test, 17.94% (n = 7) of cases of lower urinary tract disorders that were incapacitating despite treatment, 15.38% (n = 6) of cases of refractory or recurrent urinary tract infection, 10.25% (n = 4) of cases of failure of medical treatment and 10.25% (n = 4) of cases of iterative hematuria. The mean duration of TURP was 53.68 min (48-57), the mean weight of the resected prostate was 58.7 g (35 and 83 g), blood loss was minimal in 92.30% (n = 36), the mean duration of irrigation-washing was 2. 5 days (1-3 days), the mean time for urinary catheterisation was 2.45 days (3 and 4 days), 5.12% (n = 2) of patients presented complications such as hemorrhage compensated by a blood transfusion. One patient developed orchiepididymitis (2.56%). The average hospital stay was 3.75 days (3-5 days). Pathological examination was in favour of BPH in 92.3% (n = 36) and the coexistence of BPH and prostate adenocarcinoma in 7.69% (n = 3). The results of TURP were considered good in 94.87% (n = 37). Mortality was nil. Conclusion: In view of our results, TURP is a reliable, elegant minimally invasive technique with low morbidity and mortality.

前列腺增生患者经尿道前列腺电切术后应用个性化护理干预对膀胱痉挛的效果分析

分析个性化护理用于经尿道前列腺电切术(TURP)治疗的前列腺增生患者护理中对预防膀胱痉挛影响。方法 60例前列腺增生患者为样本,均接受TURP治疗,时间2022年9月-2023年9月,随机分组。A组个性化护理,B组常规护理。结果 A组术后膀胱痉挛发生率、SAS评分、SDS评分、VAS评分、SF-36评分均优于B组,P<0.05。结论 TURP治疗前列腺增生患者接受个性化护理,可减轻术后疼痛、稳定患者情绪,还可减少膀胱痉挛发作,高效可行。

TURP、TUIP及前列腺绿激光选择汽化术治疗重度前列腺增生疗效

目的:分析重度前列腺增生患者采用TURP、TUIP及前列腺绿激光选择汽化术治疗的价值。方法:筛选81例重度前列腺增生患者作为研究对象,分3组(每组27例),A组给予前列腺绿激光选择汽化术治疗,B组给予TUIP治疗,C组给予TURP治疗,比较3组临床指标、并发症率、尿动力学指标、手术指标。结果:治疗后C组前列腺症状评分低于A组、B组,生活质量评分高于A组、B组(P<0.05);A组患者并发症发生率(29.63%)高于B组(11.11%)和C组(3.70%),B组高于C组(P<0.05);治疗后C组残余尿量低于A组、B组,最大尿流率高于A组、B组(P<0.05);C组手术时间、住院时间、膀胱冲洗时间短于A组、B组,A组导管留置时间短于B组、C组(P<0.05)。结论:选择经尿道前列腺电切术对重度前列腺增生进行治疗可改善其前列腺症状及生活质量,亦可减少手术对尿流率及预后效果的影响。

纳布啡联合舒芬太尼对经尿道前列腺电切术后镇痛的效果

目的 探讨纳布啡联合舒芬太尼对经尿道前列腺电切术(transurethral resection of the prostate,TURP)后镇痛、应激反应的影响。方法 选取在本院实施TURP手术的80例老年男性患者,采用简单随机分组将患者分为观察组和对照组,每组40例。对照组给予舒芬太尼,观察组给予纳布啡联合舒芬太尼。采用视觉模拟评分(Visual Analogue Scale,VAS)和Ramsay镇静评分评估观察组与对照组患者术后镇痛效果,记录患者入室后(T_(0))、手术中(T_(1))及手术后12 h(T_(2))的应激反应指标,检测术前、术后动脉血Na^(+)、K^(+)、C1^(-)、tPSA、血糖和C反应蛋白(C-reactive protein,CRP)等生化指标,观察苏醒期质量指标(自主呼吸恢复时间、拔管时间和有效镇痛时间)及不良反应发生情况。结果 T_(0)、T_(1)时,观察组和对照组的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)无明显差异(P>0.05),T_(2)时观察组HR与MAP均低于对照组(P<0.05);T_(0)、T_(1)、T_(2)时,对照组和观察组的动脉血氧饱和度(arterial oxygen saturation,SpO_(2))无明显差异(P>0.05);术后6、12、24、48 h,观察组VAS低于对照组;观察组Ramsay镇静评分高于对照组(P<0.05);动脉血Na^(+)、K^(+)、C1^(-)术前和术后无明显差异(P>0.05),术后tPSA和血糖水平较术前均明显降低(P<0.05);术后24、48 h 2组CRP水平均持续上升,在术后48 h达到最高,且观察组高于对照组(P<0.05);观察组自主呼吸恢复时间明显短于对照组(P<0.05);观察组和对照组拔管时间和有效镇痛时间均无明显差异(P>0.05)。结论 纳布啡与舒芬太尼联合应用在老年TURP后,可以减轻应激反应,达到镇痛、镇静的效果,促进患者的麻醉苏醒。

经尿道前列腺钬激光剜除术治疗良性前列腺增生的疗效研究

目的 研究分析前列腺钬激光剜除术(Ho LEP)治疗良性前列腺增生(BPH)临床疗效。方法 选取2021年1月至2022年2月本院收治的BPH患者共60例作为研究对象,按手术方法不同将60例患者分为2组,其中观察组30例行HoLEP治疗,对照组30例行TURP治疗。结果 观察组术中出血量、留置尿管时间、住院时间均小于对照组(P<0.05);2组患者术后3 d及1周的白细胞介素-6(IL-6)、C-反应蛋白(CRP)指标水平均明显小于对照组(P<0.05);观察组术后6个月的国际前列腺症状评分(IPSS)、生活质量评分(QoL)均小于对照组(P<0.05);术后6个月,观察组的最大尿流率提高更为明显,且对照组残余尿量、前列腺体积均明显大于观察组(P<0.05)。结论 采用钬激光剜除术治疗BPH可以获得较好的疗效,且炎症反应小,患者术后生活质量改善明显,适合临床选择应用。

经尿道前列腺电切除术、剜除术及选择性绿激光前列腺汽化术治疗老年良性前列腺增生临床疗效对比

目的本研究对经尿道前列腺电切除术(TURP)、剜除术(TUEP)及选择性绿激光前列腺汽化术(PVP)在治疗老年良性前列腺增生中临床疗效的差异进行分析。方法研究对象选择2020年3月—2023年1月在本院接受前列腺手术80例患者为研究对象,依照手术方式的不同将患者分为TURP组(n=26)、TUEP组(n=27)及PVP组(n=27),对比三组患者的术中指标、术后恢复情况以及不良反应方式情况。结果三组患者的手术时间、术中出血量、术后膀胱冲洗用时以及留置导管时间均存在差异(P<0.05),其中TURP组>TUEP组>PVP组;术后3个月,三组患者的PVR、Qmax、IPSS评分以及QOL评分相比于术前均有改善(P<0.05),但三组患者PVR、Qmax、IPSS评分以及QOL评分的组间对比无差异(P>0.05);三组患者的不良反应发生率对比差异无意义(P>0.05)。结论TURP、TUEP及PVP的手术方式在老年良性前列腺增生患者的治疗中均有较好的临床效果。TURP虽然有操作时间长,出血多的缺陷,但一般预后良好;与PVP相比,TUEP的操作时间更短,出血更少。在实际操作中,医生应根据患者的具体情况,选择合适的手术方式。

经尿道前列腺双极等离子剜除术(TUPEP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生症的临床疗效对比分析

对比分析良性前列腺增生症经尿道前列腺双极等离子剜除术(TUPEP)、经尿道前列腺电切术(TURP)不同治疗方法的临床疗效。方法 对收治的60例进行分组,对照组采用TURP治疗,治疗组采用TUPEP治疗,并对比分析。结果 治疗组临床疗效96.67%(29/30)显著高于对照组的,近远期并发症发生率上结果对比为6.67%(2/30),明显低于对照组(P<0.05);两组在引流时间、术中失血量、手术时间上差异突出,治疗组显著低于对照组(P<0.05)。结论 TUPEP在良性前列腺增生症患者治疗中是一种安全、可行、经济、高效的治疗模式,在围治疗期改善患者经济指标及其预后上更具安全性,值得在该类患者的治疗环节加以应用实施。

速尿和3%高渗盐水在预防经尿道电切综合征(TUPPS)的探讨

目的探讨经尿道前列腺电切术(TURP)中,输注速尿和3%高渗盐水对预防经尿道电切综合征(TURPS)的作用。方法100例前列腺电切患者,随机分为观察组(速尿20mg+3%高渗盐水100mL组),对照组(注射用水2mL+5%葡萄糖100mL液组),记录术前、术后血电解、血糖、渗透压、CVP、MAP和灌洗液吸收量。结果对照组出现3例经尿道电切综合征(TURPS),观察组与对照组血电解质和血糖术后的变化差异有显著性,对照组术前、术后的变化差异有显著性;观察组与对照CVP、渗透压、灌洗液吸收量术后的变化差异有显著性,对照组术前、术后的变化差异有显著性。结论在手术中给予速尿和3%高渗盐水对TURPS的预防有一定作用。

Practice of Endo-Urology in the Centre of Ivory Coast: Overview and Results

Background: Endoscopic exploration and treatment of urinary tract disorders, whether by retrograde, percutaneous or endoscopic approach, defines endo urology. Objective: To report the results of endo urology practice in Bouaké during the two practice sessions. Patients and Methods: Cross-sectional and descriptive study of patients followed up and had benefited from exploration and/or endoscopic surgery in Bouaké. Our study was carried out in a facility in Bouaké, for two years, from January 2021 to December 2022. The parameters of interest were clinical, diagnostic, endoscopic procedure and results. Results: During the study period, 157 patients underwent endoscopic exploration and/or intervention. The mean age was 58.9 years (range 28 - 90 years). Males predominated with 95.5% (n = 150). Acute urinary retention was the most frequent reason for consultation (55.41%). Benign prostatic hyperplasia (BPH) was the most frequent pathology at 22.92% (n = 36). Urethrocystoscopy was performed in 52 cases (33.12%), Transurethral resection of the prostate (TURP) in 36 cases (22.92%), Endoscopic resection of secondary cervical sclerosis in 23 cases (14.64%), Endoscopic internal urethrotomy (EUI) in 15 cases (9.55%) and Transurethral resection of the bladder (TURB) in 10 cases (6.36%). Post-operative management was straightforward in 93.63% of cases (n = 147). Operative times of between 21 and 35 minutes were more frequent in 55.41% of cases (n = 87). Urinary tract infections accounted for 3.8% (n = 6) of surgical morbidity. The germ responsible for the infections was essentially Escherichia coli (E. coli). The mean duration of post-operative urinary drainage was 5.5 days (range: 4 - 6 days) for patients who underwent TURP, TURB and endoscopic resection of secondary sclerosis of the bladder neck. The mean duration of drainage after endoscopic internal ureterotomy was 21.6 days (range 14 - 30 days). Of the 157 endoscopies performed, 154 patients (98.08%) had a favourable outcome, with adenomyofibroma of the prostate being the most common histological type (52.17%, n = 36). Mortality was 1.27% (n = 2) in our series. Conclusion: Endo urology should be the urologist’s first choice for both exploration and surgery, given the satisfactory results.

Bipolar Transurethral Resection of the Prostate (B-TURP) Including Large Prostate Glands in Kinshasa, DR Congo

Context: In DR Congo, prostate adenoma was treated solely by open surgery till the practice of minimally invasive surgery in 2012. Surgical management of large prostate glands has greatly improved over the last years. Even if open adenomectomy is indicated for prostate glands > 80 ml, TURP is currently the gold standard. We report the resection time of TURP procedure, quality of life of the patients, the postoperative complications and outcomes of 152 patients with large prostate glands who went under Bipolar TURP from 2021 to 2022. Patients and Methods: This is a prospective and evaluative study of 152 patients who underwent surgery for benign prostatic hyperplasia (BPH) from January 2021 to December 2022 using bipolar transurethral resection of the prostate (TURP). The study variables were age, low urinary tract symptoms (LUTS), paraclinical parameters, prostate volume, resection time, length of hospital stay, results of histopathological analysis of resected tissues (prostate chips), complications and postoperative outcomes of the patients. All the patients underwent saline bipolar TURP. Results: The mean age of the patients was 66.5 ± 9.3 years. Dysuria and acute urinary retention were the most predominant symptoms, 46.1% and 23.03% respectively. Arterial hypertension was the most common medical history (29.7%), or associated with diabetes mellitus (18.4%). The most frequent surgical history was the repair of the inguinal hernia in 21.7% of cases. Most of the patients had a prostate volume ≥ 80 ml (n = 91) in a relative frequency of 60% of cases. The mean prostate volume was 104.8 ± 60.4 ml. The volume of the prostate was correlated with the age of the patients (r = 0.321;p 15 ml/s (96%) postoperatively. The post-void residual (PVR) was significant in the group of patients with prostate volume ≥ 80 ml (p Conclusion: Although conventional surgery (open adenomectomy) has been a standard treatment for large prostate adenomas, progress in minimally invasive techniques, mainly Bipolar TURP, seems to confer more advantages such as the low rate of complications, reduced length of hospital stay and improved quality of life for the patients.

甲哌卡因在TURP术中的临床应用研究

目的探讨甲哌卡因在经尿道前列腺电切术(TURP)中的临床应用。方法前瞻性研究2021年3月至2022年6月于遵义医科大学第五附属(珠海)医院因前列腺增生(BPH)前来就诊,经临床诊断及手术指征明确,需择期行TURP的患者60例,随机分为两组,分别为观察组(n=30)及对照组(n=30)。对照组给予利多卡因+罗哌卡因,观察组给予甲哌卡因。比较两组麻醉时间、效果以及满意度;比较两组患者术中收缩压(SBP)、舒张压(DBP)以及平均动脉压(MAP);比较两组不良反应发生率。结果观察组的感觉及运动阻滞的起效时间较对照组更快,感觉与运动的阻滞持续时间短于对照组,差异有统计学意义(P<0.05)。观察组的麻醉效果和满意度均高于对照组,差异有统计学意义(P<0.05)。T1、T2时观察组的SBP、DBP以及MAP均高于照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异无统计学意义(P>0.05)。结论甲哌卡因骶管阻滞用于TURP术中,起效时间较快,麻醉效果确切,且维持术中血流动力学指标较稳定,安全性较高,且术后感觉及运动功能恢复较快,更有利于患者的快速康复。

Endoscopic Management of Secondary Sclerosis of the Bladder Neck in Bouaké: Our Experience with 23 Cases

Background: Secondary sclerosis of the bladder neck is a rare but serious late complication that occurs after open or endoscopic prostatic adenomectomy. Objective: The aim of this study was to report the results of endoscopic management of secondary sclerosis of the bladder neck in a series of 23 cases. Patients and Methods: Cross-sectional study of 23 patients presenting with secondary sclerosis of the bladder neck following adenomectomy and treated by endoscopic resection of the bladder neck in a private facility in Bouaké (Ivory Coast) over the period from 1 January 2021 to 1 December 2022, i.e. 2 years. The mean age of the patients was 61, 7 years with extremes from 53 to 76 years. The diagnosis of secondary sclerosis of the cervix was based on clinical and radiological data (retrograde uretrocystography). The parameters studied were the reason for consultation, time to onset of signs after adenomectomy, clinical data, results of retrograde uretrocystography (RUC), results of urine cytobacteriological examination (UCT), complications, endoscopic procedure, duration of operation, duration of postoperative urinary drainage, duration of hospitalization, postoperative follow-up and operative morbidity and mortality. Results: 23 patients with secondary sclerosis of the bladder neck were treated by endoscopic neck resection. The mean age of the patients was 61.7 years (5 - 76 years). Dysuria was the most frequent reason for consultation, accounting for 73.9% (n = 17). Retrograde uretrocystography (RUC) was used to make the diagnosis in all patients. It found a steam jet image in 69.6% (n = 16) and tight stenosis of the bladder neck in 30.4% (n = 7). Secondary stenosis of the bladder neck was complicated by uretrohydronephrosis in 47.8% (n = 11). 73.9% of patients had a post-micturition residual of more than 150 ml. The urine cytobacteriological examination (UCE) found four urinary tract infections (17.4%) treated with antibiotics over 14 days, which sterilised the urine. The pathologies associated with cervical sclerosis were urethral stricture (13%) treated by endoscopic internal urethrotomy, and urinary lithiasis (8.7%) (n = 2). The mean duration of the operation was 53 minutes (43 - 60 min), the mean duration of postoperative urinary drainage was 3 days (2 - 6 days), and the mean duration of hospitalization was 5.4 days (3 - 6 days). Follow-up at 3 and 6 months using retrograde uretrocystography (RUC) showed good permeability of the neck and urethra with a post-void residual of less than 20 ml (10 - 36 ml). There was no morbidity. Conclusion: Secondary sclerosis of the bladder neck is a late but serious condition because of its obstructive and recurrent nature.

经尿道前列腺电切术治疗前列腺增生合并前尿道狭窄效果探讨

选用样本对比分析采用经尿道前列腺电切术治疗前列腺增生合并前尿道狭窄的具体临床效果。方法随机的从我院2020年6月至2022年6月之间接诊治疗的前列腺增生合并前尿道狭窄患者88例进行对比研究,按照电脑随机数表法将其平均地分为两组,其中一组按照我院常规的开放性手术进行治疗,而对于另外一组患者则采用TURP(经尿道前列腺电切术)进行治疗。治疗完毕之后对两组患者的各项数据进行对比,其中有IPSS(前列腺症状)评分、Qave(平均尿流率)、Qmax(最大尿流量)、RUV(残余尿量)等指标。结果 采用不同的手术方法治疗之后,患者的各项指标出现了明显的好转趋势,但是从组间的对比情况看采用TURP手术的患者的各项指标优于常规开放式手术患者。结论 TURP在治疗前列腺增生合并前尿道狭窄患者中效果良好,患者的各项指标均得到了明显的好转,且安全性良好,患者的预后能够达到预期,因此可以将该方法在临床中推广使用。

经尿道前列腺等离子电切术(TURP)术后持续膀胱冲洗堵管护理干预临床研究

分析经尿道前列腺等离子电切术(TURP)术后持续膀胱冲洗堵管的影响因素,并通过早期观察、干预和积极进行针对性护理措施来降低持续膀胱冲洗堵管率。方法 收集72例广东省某三甲医院泌尿外科收治的拟采取TURP治疗的BPH患者,随机分成两组,治疗组与对照组各36例。对照组给予常规护理,治疗组采取针对性护理,对干预前后进行比较。结果 干预后治疗组堵管情况显著低于对照组(P<0.05),两组患者在腹胀不适、排尿急迫感、便意急迫感、膀胱区疼痛、冲洗液逆流、尿管周围溢尿方面有明显差异(P<0.05)。结论 针对性护理对经尿道前列腺等离子电切术(TURP)术后持续膀胱冲洗堵管情况改善明显,值得进一步推广与探讨。

TURP术后排尿困难的临床分析及处理

目的:探讨经尿道前列腺电切术(trans-urethral resection of prostate,TURP)后排尿困难的病因及处理。方法:回顾性分析22例TURP术后出现排尿困难患者的临床资料及治疗方法。结果:术后发生腺体及异物残留3例,尿道狭窄5例,膀胱颈挛缩和逼尿肌无力各7例,均经治疗后恢复。结论:腺体残留、尿道狭窄、膀胱颈挛缩、逼尿肌无力是TURP术后排尿困难的主要原因。正确的术前诊断及术中、术后处理是预防TURP术后发生排尿困难的关键。

TURP术后尿道狭窄临床分析及对策研究

目的探讨经尿道前列腺切除术(transurethral resection of prostate,TURP)术后尿道狭窄的预防及诊治策略。方法回顾性分析2006-2010年本科104例TURP术后尿道狭窄患者临床资料,总结患者术后临床症状、发病时间、狭窄发生部位及疗效,结合临床检查情况进行分析。结果前列腺增生患者TURP术后尿道狭窄发生率为(4.44%,104/2 341);TURP术后尿道狭窄多发生于术后1年内,术后4～6个月为本组尿道狭窄发生高发期(41.35%,43/104);TURP术后尿道狭窄最常见狭窄部位为膜部尿道(35.58%,37/104),其次为尿道外口(21.15%,22/104)、膀胱颈(18.27%,19/104)及悬垂部(15.38%,16/104)。结论加强手术操作技能训练、尿管护理及充分润滑有助于预防TURP术后尿道狭窄的发生,治疗需要根据尿道狭窄部位及程度进行选择。

宫腔镜电切术治疗子宫粘膜下肌瘤及发生TURP综合征分析

目的：探讨宫腔镜电切术（TCRM）治疗子宫粘膜下肌瘤的价值和发生经尿道前列腺切除TURP综合征的诱发因素以及并发症的预防措施。方法：对2001年1月-005年11月期间采用TCRM治疗子宫粘膜下肌瘤80例及发生并发症1例进行临床分析。结果：80例中77例在B超监护下完成手术，3例在腹腔镜监护下手术，切除粘膜下肌瘤90个，0型45个。Ⅰ型37个，Ⅱ型8个，肌瘤重量2—100g，（18．6±14．8）g，手术时间10-60min，（29．9±11．3）min，失血量5—50ml。（20．1±9．1）ml，1例发生TURP综合征，经积极抢救治疗后痊愈。术后随访所有病人，月经量均明显减少，1例术后4年因多发性子宫肌瘤行全子宫切除术。结论：充分做好术前准备，做好各项预防措施，TCRM术是1种安全、有效的方法。