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目的:探讨经尿道前列腺汽化剜切术治疗良性前列腺增生症(BPH)的疗效及其安全性。方法:2012年7月~2016年1月对657例BPH患者应用等离子纽扣电极结合环状电极行经尿道前列腺汽化剜切术治疗。观察患者手术时间、切除前列腺组织重量、失血量、尿管留置时间、住院时间、围手术期并发症情况;对患者术前术后国际前列腺症状评分(IPSS),生活质量指数评分(QOL),最大尿流率(Qmax)、剩余尿量(RUV)进行了随访评估。结果:本组657例患者均顺利完成手术。患者年龄59~87岁,平均67.3岁。术前超声检查测量前列腺体积36~135ml,平均69.5ml。手术采用硬膜外阻滞麻醉或全麻。手术时间50~145min,平均69min。切除前列腺组织重量(43.4±12.8)g。手术前后血红蛋白浓度分别为(121.4±2.7)g/L和(115.8±3.2)g/L,P>0.05。术后留置导尿管时间(3.1±l.8)d。术后住院时间(4.6±1.5)d。未发生明显出血及经尿道电切综合征,无患者输血。术后3个月随访IPSS由术前(15.6±6.8)分降至术后(6.7±2.4)分,QOL评分由术前(5.4±0.3)降至术后(1.6±0.6)分,Qmax由术前(5.3±0.4)ml/s提高至术后(16.8±2.7)ml/s,RUV由术前(115.3±36.4)ml减少至术后(14.1±2.3)ml,手术前后比较差异均有统计学意义(P<0.01)。结论:经尿道前列腺汽化剜切术是一种治疗BPH安全有效的可选择方法。
Objective: To investigate the efficacy and safety of transurethral vaporization of the prostate in the treatment of benign prostatic hyperplasia (BPH). Methods: From July 2012 to January 2016, 657 patients with BPH were treated with plasma button electrode and ring electrode via transurethral vaporization and resection of the urethra. The patients’ preoperative and postoperative global prostate symptom scores (IPSS), quality of life index (QOL), postoperative complications and postoperative complications were observed, including the time of operation, the removal of prostate tissue weight, blood loss, catheter indwelling time, hospitalization time and perioperative complications. Maximum flow rate (Qmax), residual urine output (RUV) were evaluated at follow-up. Results: The group of 657 patients were successfully completed the operation. Patients aged 59 to 87 years, mean 67.3 years. Preoperative ultrasound examination of prostate volume 36 ~ 135ml, an average of 69.5ml. Surgical epidural anesthesia or general anesthesia. Surgery time 50 ~ 145min, an average of 69min. Prostate tissue weight (43.4 ± 12.8) g. The hemoglobin concentrations before and after surgery were (121.4 ± 2.7) g / L and (115.8 ± 3.2) g / L, respectively, P> 0.05. Postoperative indwelling catheter time (3.1 ± l.8) d. Postoperative hospital stay (4.6 ± 1.5) d. No significant bleeding and transurethral resection syndrome, no patient transfusion. The IPSS decreased from 15.6 ± 6.8 to 6.7 ± 2.4 at 3 months after operation. The QOL decreased from 5.4 ± 0.3 to 1.6 ± 0.6 preoperatively and Qmax decreased from Preoperative (5.3 ± 0.4) ml / s increased to postoperative (16.8 ± 2.7) ml / s, RUV decreased from 115.3 ± 36.4 ml to (14.1 ± 2.3) ml preoperative and postoperative Statistical significance (P <0.01). Conclusion: Transurethral vaporization of the prostate is an effective and safe alternative to BPH.