摘要
目的探讨经尿道等离子体双极电切术（transurethral bipolar plasmakinetic resection of the prostate，TUPKRP）治疗前列腺增生症（benign prostatic hyperplasia，BPH）的安全性。方法应用CIRCON等离子体双极电切系统，采用分隔切除法，先于5、7、12点切沟，将前列腺中叶及左、右侧叶分隔成3块。再分别将其切除，膀胱颈部切平，显露环状纤维，前列腺尖部切至精阜前缘，保留F20或F22三腔导尿管，气囊放置膀胱颈部。术后生理盐水冲洗1～2d，导尿管3～5d拔除。结果切割时间20～180min，（53．2±28．7）min；切除前列腺组织重量8～130g，（23．5±21．6）g；术中出血量10～300ml，（65．4±46．8）ml，无一例输血。无一例发生包膜穿孔，无电切综合征发生。术后1个月最大尿流率（Qmax）由术前的（8．4±1．9）ml／s上升至（18．4±1．8）ml／s（q=55．498，P〈0．05）；剩余尿量（residual urine，RU）由术前（80．8±59．7）ml下降至（19．5±10．0）ml（q=17．287，P〈0．05）；国际前列腺症状评分（international prostate symptom score，IPSS）由术前（25．7±5．5）分下降至（5．7±2．4）分（q=52．969，P〈0．05）；生活质量评分（quality of life due，QOL）由术前（4．4±1．0）下降至（1．1±0．2），（q=42．146，P〈0．05）。结论TUPKRP治疗BPH安全有效，并发症少，值得推广。
Objective To assess the efficacy and safety of transurethral bipolar plasmakinetic resection of the prostate （TUPKRP） for the treatment of benign prostatic hyperplasia （BPH）. Methods The operation was completed using a bipolar plasmakinetic resection system （CIRCON ACMI）. Three trenches were created at 5, 7, and 12 o＇ clock position, respectively, to divide the middle, left, and right lobes of the prostate gland for resection. The bladder neck was widened in overlapping vaporizing swathes to create a wide-necked funnel down to the level of the surgical capsule. The apical tissue was resected to the anterior border of the seminal colliculus. With a F20 or F22 three-cavity catheter indwelling for 3 - 5 d, normal saline irrigation was used for 1 - 2 d postoperatively. Results The duration of the procedure was 20 - 180 min （53.2 ± 28.7 min） , and resected tissue weighed 8 - 130 g （23.5 ± 21.6 g）. The intraoperative blood loss was 10- 300 ml （65.4 ± 46.8 ml） and no blood transfusion was required. No perforation of the prostatic capsule or transurethral resection syndrome occurred. The peak urinary flow rate （Qmax） increased from 8.4 ± 1.9 ml/s preoperatively to 18.4 ± 1.8 ml/s 1 month postoperatively （q = 55. 498, P 〈 0.05）. The residual urine （RU） decreased from 80.8 ± 59.7 ml preoperatively to 19.5 ± 10.0 ml postoperatively （q = 17. 287, P 〈 0.05）. The international prostate symptom score （IPSS） decreased from 25.7 ± 5.5 preoperatively to 5.7 ± 2.4 postoperatively （ q = 52. 969, P 〈 0.05 ）. The scores of quality of life （QOL） decreased from 4.4 ± 1.0 preoperatively to 1.1 ± 0.2 postoperatively （ q = 42. 146, P 〈 0.05）. Conclusions Transurethral bipolar plasmakinetic resection of the prostate for the treatment of benign prostatic hyperplasia is effective and safe, with few complications.
出处
《中国微创外科杂志》
CSCD
2006年第8期608-610,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
前列腺增生症
等离子体双极电切术
Benign prostatic hyperplasia
Bipolar plasmakinetic resection
