摘要
目的探讨经尿道双极等离子电切术治疗女性膀胱颈梗阻的疗效。方法采用经尿道膀胱颈电切术(TURBN)加钩状电极颈口切开治疗63例女性膀胱颈梗阻。术前均行尿流动力学检查和膀胱镜检查,45例行经尿道膀胱颈后唇切除术,18例行经尿道膀胱颈后唇切除术加膀胱颈12点位纵行切开术。结果平均手术时间15(10～46)min,失血<10ml,无水中毒及尿失禁发生。术后病理报告为膀胱颈黏膜下纤维组织增生伴玻璃样变性,部分平滑肌变性增生及黏膜下炎性细胞浸润。本组63例均获随访,平均13.5(1～24)个月,治疗后生活质量评分由4.3±1.2降至1.6±0.5(P<0.01),最大尿流率由4.8±2.6ml/s升至19.2±5.8ml/s(P<0.01),残余尿量由320.5±168.5ml降至26.3±16.4ml(P<0.01)。结论经尿道双极等离子电切术是治疗女性膀胱颈梗阻的有效方法。
Objective To explore the effect of transurethral bipolar plasma kinetic resection in the treatment of female bladder neck obstruction.Method Sixty-three female patients suffered bladder neck obstruction who were treated by transurethral resection and discission of bladder neck.All the patients underwent urodynamic study and cystoscopy.Fourty-five cases received transurethral resection of posterior lip of bladder neck.Eighteen received former described procedure plus microtubule section at 12 clock.Results The mean operative duration was 15 minutes（10 to 46 minutes）.The mean blood loss was less than 10 ml.No overhydration or urinary incontinence occurred.The pathology of bladder neck showed fibroustissue hyperplasia of submucosa,concomitant degeneration and chronic inflammation invading into partial smooth muscles.All cases were followed up for 1 to 24 months（mean 13.5 months）.After operation,the quality of life（QOL） score decreased from 4.3±1.2 to 1.6±0.5,（P0.01）,maximum flow rate（Qmax） increased from 4.8 ±2.6 ml/s to 19.2±5.8 ml/s,（P0.01）,and post void residual urine（PVR） decreased from 320.5±168.5 ml to 26.3±16.4 ml（P0.01）.Conclusion Transurethral bipolar plasma kinetic resection of the bladder neck is an effective procedure for female bladder neck obstruction.
出处
《中华腔镜泌尿外科杂志（电子版）》
2011年第1期41-43,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
膀胱颈梗阻
经尿道电切术
双极等离子
女性
Bladder neck obstruction
Transurethral resection
Plasma kinetic resection
Female
