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目的总结高危良性前列腺增生(BPH)患者行经尿道前列腺等离子大标本电切术(TUIRP)的临床效果。方法回顾性分析38例高危大体积BPH行TUIRP患者的临床资料,分析其临床效果。结果手术均获得成功。手术时间(54.8±10.3)min,前列腺组织重(69.7±10.4)g,术中出血量(95.6±12.8)ml,5例给予输血治疗。术中无包膜穿孔、水中毒及闭孔神经反射发生。术后有5例发生出血,膀胱痉挛4例,尿路感染5例,暂时性尿失禁2例,尿道狭窄2例。与术前比较,术后国际前列腺症状评分下降[(11.5±2.2)分vs.(25.7±3.1)分],尿流率加快[(13.1±3.6)ml/s vs.(5.4±3.9)ml/s],残余尿量减少[(39.5±10.2)ml vs.(228.5±63.5)ml],生活质量指数改善(2.4±0.4vs.5.2±0.7)(P<0.05)。结论高危大体积BPH患者行TUIRP安全、有效。
Objective To summarize the clinical effect of transurethral resection of prostate (TUIRP) in patients with benign prostatic hyperplasia (BPH). Methods The clinical data of 38 patients with high-risk and large-volume BPH underwent TUIRP were retrospectively analyzed. The clinical effect was analyzed. The results of surgery were successful. The operation time (54.8 ± 10.3) min, prostate tissue weight (69.7 ± 10.4) g, blood loss (95.6 ± 12.8) ml and blood transfusion in 5 patients. No intraoperative perforation, water poisoning and obturator nerve reflex occurred. Postoperative bleeding in 5 cases, 4 cases of bladder spasm, urinary tract infection in 5 cases, 2 cases of temporary urinary incontinence, urethral stricture in 2 cases. Postoperative global prostate symptom score decreased (11.5 ± 2.2 vs. 25.7 ± 3.1) and urinary flow rate accelerated (13.1 ± 3.6 vs. 5.4 ± 3.9, / s]. The residual urine volume decreased (39.5 ± 10.2) ml vs. (228.5 ± 63.5) ml], and the quality of life index improved (2.4 ± 0.4 vs. 5.2 ± 0.7) (P <0.05). Conclusions TUIRP is safe and effective in high-risk and large-volume BPH patients.