目的 探讨以普通电切镜经尿道行前列腺剜除术(transurethral enucleative resection of prostate,TUERP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的效果。方法 回顾性分析86例采用TUERP治疗BPH患者的临床资料,分别比较术前、术后国际前列腺症状评分(IPSS)、生活质量指数(QOL)、最大尿流率(Qmax)、残余尿量(PVR)情况。结果 手术均顺利完成,平均手术时间(62.7±19.3)min,切除腺体平均重量(37.2±8.5)g。术后IPSS由术前(23.9±5.2)分降至(5.4±3.7)分,QOL由术前(4.6±1.1)分降至(1.2±0.9)分,Qmax由术前(6.3±2.0)ml/s上升至(21.0±3.6)ml/s,PVR由术前(149.0±35.8)ml降至(21.2±9.9)ml。术后3例出现暂时性尿失禁,1例出现尿道外口狭窄,经治疗后痊愈。结论 TUERP术具有手术时间短、并发症少、术后恢复快、症状解除明显等优点,是治疗BPH的安全、有效的治疗方法 。
Abstract
Objective To investigate the efficacy of transurethral enucleative resection of prostate(TUERP) with conventional resectoscope in the treatment of benign prostatic hyperplasia(BPH).Methods The clinical data of 86 BPH patients treated with TUERP were analyzed retrospectively.International Prostate Symptom Score (IPSS), the index of life quality (QOL), maximum urinary flow rate(Qmax) and residual urine volume (PVR)before and after the treatment were compared respectively.Results The operation was completed successfully in all the 86 patients, and the average operation time was(62.7±19.3)min;the average removed glands were (37.2± 8.5) g in weight.The IPSS decreased from(23.9±5.2)points to(5.4±3.7) points; QOL decreased from(4.6±1.1)points to(1.2± 0.9)points;Qmax increased from(6.3±2.0)ml/s to (21.0±3.6) ml/s; PVR decreased from(149.0±35.8)ml to (21.2±9.9)ml. Three patients had postoperative transient urinary incontimence, and 1 patient had urethral stricture,but recovered after treatment.Conclusions Compared with transurethral resection of prostate (TURP), TUERP has the advantages of short operation time, less complications, quick recovery and obvious symptom relief. It is a safe and effective therapy for BPH.
关键词
前列腺良性增生 /
经尿道前列腺剜除术 /
经尿道前列腺电切术
Key words
benign prostatic hyperplasia /
transurethral enucleative resection of prostate /
transurethral resection of the prostate
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Jacobsen S J,Girman C J,Lieber M M.Natural history of benign prostatic hyperplasia[J].Urology,2001,5(10):231-234.
[2] 那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南[M].2014版.北京:人民卫生出版社,2013:259.
[3] Fong Y K, Milani S, Djavan B R. Natural history and clinical predictors of clinical progression in benign prostatic hyperplasia [J].Curr Opin Urol,2005,15(1): 35-38.
[4] 席志军,宁新荣,潘柏年,等.TUR-P手术切除前列腺组织重量及比例分析[J].中华泌尿外科杂志,2001,22(4):232-234.
[5] 朱 凯,许 宏,尚 平.B超测量与手术切除前列腺重量的比较[J].中华男科学,2001,7(1):63.
[6] 刘春晓.传统经尿道前列腺电切术不应再是前列腺增生腔内治疗的金标准[J].现代泌尿外科杂志,2012,17(3):298-299.
[7] Liu C X,Xu A B,Zheng S B,et al.Transurethral enucleative resection of prostate for treatment of BPH with plasmakinetic system[J].J Endourol,2005,19(Suppll):273.
[8] Liu C X,Zheng S B,Li H L,et al.Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J].J Urol,2010,18(4):2440-2445.
[9] 单存密,柳荣强,王德昕,等. 应用普通电切镜行经尿道前列腺剜除术1000例报告[J].现代泌尿外科杂志,2013,18(2):198-199.
[10] Lee N G,Xue H,Lemer L B.Trends and attimdos in surgical management of benign prostatic hyperplaaia [J].Can J Urol,2012,19(2):6170-6175.
[11] Gandaglia G,Briganti A,Gontero P,et al.The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH) [J].BJU Int,2013,112(4):432-441.
[12] 阮 黎,华 兴,李 刚.组织学前列腺炎对经尿道前列腺剜除术的影响及临床意义[J/CD].中华腔镜泌尿外科杂志:电子版,2014,8(2):81-84.
PDF(719 KB)
