经尿道等离子双极汽化电切术治疗高危前列腺增生症的临床研究
摘要
目的：评价经尿道等离子双极汽化电切术(TUPKVP)治疗高危前列腺增生症的临床疗效及其手术安全性。
方法：回顾我院泌尿外科高危BPH患者38例,纳入标准为年龄≥75岁且至少合并1种以上老年常见疾病,予行TUPKVP治疗。术前常规化验生化、血常规及血凝,行泌尿系B超测量前列腺体积、残余尿量(RUV),行尿动力学检查并测量最大尿流率(Qmax),进行国际前列腺症状评分(IPSS)及生活质量评分(QOL)。观察手术时间、术中出血量、手术结束时血钠及血糖变化,术后膀胱冲洗时间、留置尿管时间及心、脑、肺、肾等合并症情况。术后随访1-3个月,进行国际前列腺症状评分(IPSS)、生活质量评分(QOL)、测定残余尿量(RUV)、测定最大尿流率(Qmax),观察手术并发症及其转归等情况。采用SPSS13.0统计软件对数据进行分析,x±s、频次法、频率表示,采用配对t检验。以P<0.05为差异具有统计学意义。
结果：38例均成功完成手术,平均手术时间45±23min,平均出血量27.5±16.8 m1,手术结束时血钠、血糖与术前比较,差异无统计学意义(p>0.05)；发生“外科包膜”穿孔1例(2.63%),无电切综合征(TURS)发生；术后发生尿道口狭窄3例(7.89%)假性尿失禁者6例(15.79%),短暂性血尿5例(13.16%),无1例原有心、脑、肺、肾合并症加重；随访1-3个月,IPSS评分、QOL评分、Qmax及RUV与术前明显改善,差异有统计学意义(p<0.05)。
结论：经尿道等离子双极汽化电切术出血少、安全性高,是治疗高危BPH患者安全有效的方法。
Objective:To evaluate the therapeutic effect and safety of plasmakenitic vaporization of prostate (TUPKVP) in the treatment of high risk benign prostatic hyperplasia (BPH).
Methods:We reviewed 38 cases who were senior benign prostatic hyperplasia in our hospital.These patients who were older than 75 years and had other complications were adopted. Before the surgery, these patients should have biochemical tests, blood routine test and coagulation function test, they also receive urinary tract ultrasound to measure the volume of the prostate, residual urine volume, urodynamics test and the maximum flow rate; International prostate symptom score (IPSS) and quality of life (QOL) scores are also observed. We still collect the data of the operative time, blood loss, the variation of blood sodium and blood glucose after the operation, bladder washing time, indwelled urinary catheter time. Heart, brain, lung, kidney and other complications of the situation are too observed. SPSS13.0 statistical software are used to analyze these data, measurement data are expressed by x±s,the frequency method, and percentage, also analyzed by paired T test, to p<0.05 as statistically significant difference.
Results:38 cases all succeeded with operation. The mean operative time was 45±23 min, blood loss was 27.5±16.8 ml, the variation of blood sodium and blood glucose before and after surgery has no statistical significance. One patient had the prostate capsule perforation, no patient had transurethral resection syndrome; After operation 3 cases suffered urethral stricture,6 cases of pseudo-incontinence,5cases of transient hematuria. No patients had aggravated complications, after 1 to 3 months following up, There were significant differences of International prostate symptom score, quality of life score, residual urine volume, urodynamics test and the maximum flow rate before and after operation (p<0.05).
Conclusion:TUPKVP can be particularly applied to high risk BPH with less bleeding and more safety.
方法：回顾我院泌尿外科高危BPH患者38例,纳入标准为年龄≥75岁且至少合并1种以上老年常见疾病,予行TUPKVP治疗。术前常规化验生化、血常规及血凝,行泌尿系B超测量前列腺体积、残余尿量(RUV),行尿动力学检查并测量最大尿流率(Qmax),进行国际前列腺症状评分(IPSS)及生活质量评分(QOL)。观察手术时间、术中出血量、手术结束时血钠及血糖变化,术后膀胱冲洗时间、留置尿管时间及心、脑、肺、肾等合并症情况。术后随访1-3个月,进行国际前列腺症状评分(IPSS)、生活质量评分(QOL)、测定残余尿量(RUV)、测定最大尿流率(Qmax),观察手术并发症及其转归等情况。采用SPSS13.0统计软件对数据进行分析,x±s、频次法、频率表示,采用配对t检验。以P<0.05为差异具有统计学意义。
结果：38例均成功完成手术,平均手术时间45±23min,平均出血量27.5±16.8 m1,手术结束时血钠、血糖与术前比较,差异无统计学意义(p>0.05)；发生“外科包膜”穿孔1例(2.63%),无电切综合征(TURS)发生；术后发生尿道口狭窄3例(7.89%)假性尿失禁者6例(15.79%),短暂性血尿5例(13.16%),无1例原有心、脑、肺、肾合并症加重；随访1-3个月,IPSS评分、QOL评分、Qmax及RUV与术前明显改善,差异有统计学意义(p<0.05)。
结论：经尿道等离子双极汽化电切术出血少、安全性高,是治疗高危BPH患者安全有效的方法。
Objective:To evaluate the therapeutic effect and safety of plasmakenitic vaporization of prostate (TUPKVP) in the treatment of high risk benign prostatic hyperplasia (BPH).
Methods:We reviewed 38 cases who were senior benign prostatic hyperplasia in our hospital.These patients who were older than 75 years and had other complications were adopted. Before the surgery, these patients should have biochemical tests, blood routine test and coagulation function test, they also receive urinary tract ultrasound to measure the volume of the prostate, residual urine volume, urodynamics test and the maximum flow rate; International prostate symptom score (IPSS) and quality of life (QOL) scores are also observed. We still collect the data of the operative time, blood loss, the variation of blood sodium and blood glucose after the operation, bladder washing time, indwelled urinary catheter time. Heart, brain, lung, kidney and other complications of the situation are too observed. SPSS13.0 statistical software are used to analyze these data, measurement data are expressed by x±s,the frequency method, and percentage, also analyzed by paired T test, to p<0.05 as statistically significant difference.
Results:38 cases all succeeded with operation. The mean operative time was 45±23 min, blood loss was 27.5±16.8 ml, the variation of blood sodium and blood glucose before and after surgery has no statistical significance. One patient had the prostate capsule perforation, no patient had transurethral resection syndrome; After operation 3 cases suffered urethral stricture,6 cases of pseudo-incontinence,5cases of transient hematuria. No patients had aggravated complications, after 1 to 3 months following up, There were significant differences of International prostate symptom score, quality of life score, residual urine volume, urodynamics test and the maximum flow rate before and after operation (p<0.05).
Conclusion:TUPKVP can be particularly applied to high risk BPH with less bleeding and more safety.
引文
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