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目的探讨等离子体双极汽化电切术治疗Ⅳ度前列腺增生症的疗效和安全性。方法在充分的术前准备后,采用经尿道等离子双极汽化前列腺切除术,患者年龄73～89岁,平均77.8岁;前列腺重量77～112.4g(97.6±24.1)g。术后随访3～l2个月。结果22例平均手术时间(133±37)min(107～165min),切除前列腺组织重量平均(82±29)g(62～93g),无一例需输血,无经尿道电切综合征(TURS)的发生,最大尿流率(Qmax)由术前0～7ml/s恢复到术后的(19.5±2.5)ml/s;国际前列腺症状评分(IPSS)由术前(27.5±2.4)下降至术后(6.7±2.2),生活质量评分(QOL)由术前的(5.1±0.4)下降至(1.8±0.4)。结论等离子体双极电切除术的术中、术后出血量少,可以避免TURP综合征的发生,疗效确切,在Ⅳ度前列腺增生症的治疗手段中,是安全、有效的手术方式。
Objective To investigate the efficacy and safety of plasma bipolar vaporization in the treatment of grade Ⅳ benign prostatic hyperplasia. Methods After adequate preoperative preparation, transurethral plasma-assisted bipolar vaporization of the prostate was performed. The patients were 73 to 89 years old with an average of 77.8 years old. The weight of the prostate was 77-112.4 g (97.6 ± 24.1) g. Follow-up 3 ~ l2 months after surgery. Results The mean operative time was (133 ± 37) min (107 ~ 165 min) in 22 patients, and the average weight of the resected prostate tissue was (82 ± 29) g (62 ~ 93g). No blood transfusion, TURS, , The maximum flow rate (Qmax) recovered from 0 ~ 7ml / s preoperatively to (19.5 ± 2.5) ml / s postoperatively; IPSS decreased from preoperative (27.5 ± 2.4) to postoperative After (6.7 ± 2.2), the QOL decreased from (5.1 ± 0.4) to (1.8 ± 0.4) before surgery. Conclusion Plasma bipolar resection with less intraoperative and postoperative blood loss can avoid the occurrence of TURP syndrome and has a definite curative effect. It is safe and effective in the treatment of grade Ⅳ benign prostatic hyperplasia.