经尿道前列腺等离子电切术联合剜除术治疗BPH的初步探讨

目的：探讨经尿道前列腺等离子电切联合剜除术治疗BPH的可行性。方法：对28例BPH患者经尿道置入前列腺等离子电切镜，常规切除中叶及左右侧叶部分前列腺组织（无须切至包膜），再以精阜为标志，于6点钟处点切的方法找到包膜，用剜除术的方法分别剜除中叶及左右侧叶，遇到剥离困难处即中止剜除，切除已剥离的组织，再以包膜为界面，逐步切除尚未剥离的前列腺组织，直至完全切除。结果：28例患者均手术成功。术后住院时间6～7d，拔管后均排尿良好。术后最大尿流率20～36ml／s，平均（28．4±5．2）ml／s，IPSS评分（4．5±2．1）分。与术前比较差异有统计学意义（P〈0．01）。结论：经尿道前列腺等离子电切结合剜除术治疗BPH是安全有效的方法，尤其适用于尚未熟练掌握前列腺剜除技术的医务人员。

Preliminary study of the transurethral plasmakinetic rsection of prostate joint enucleation to treat the benign prostatic hyperplasia

To investigate the feasibility of transurethral plasma rsection of prostate（PKRP） joint transurethral plasmakinetie enucleation of prostate（PKEP） to treat the benign prostatic hyperplasia（BPH）. Method：Twenty eight cases of patients with benign prostatic byperplasia were studied： the average age 72.4 years （62- 83 years）; the size of the prostate 45-105 g, means （68.5±10.5） g; 15 cases of merger urinary retention： Maximum flow rate 0 12 ml/s, means （4.7±2.3） ml/s; IPSS score （24.5±4.3）. Implanta prostate plasma resectoscope, routine remove of the mid, left and right side of the prostate tissue （no need to cut to the capsule）, remove the prostate tissue at 6 o＇clock of verumontanum to find the capsule, resect the middle, left and right side of the leaf in the way of enucleation, stop conducting when enucleation is diffcult and resect the tissue stripped. Finally, gradually resect the not yet stripped prostate tissue in boundary of the capsule. Result： Twenty＇eight patients were successfully operated. Postoperative hospitalization time is 6-7 days. All the patients urinated well after extubation. Postoperative maximum flow rate was 20-36 ml/s, means （28.44±5.2） ml/s. IPSS score was （4.5±2.1） minutes. There was a significant difference compared with the preoperative（P〈0.01）. Concluslon：The transure lhral plasma rsection of prostate joint enucleation is safe and effective. It is particularly suitable for the doctor not yet mastered the enucleation of the prostate .