经尿道双极等离子汽化电切治疗膀胱肿瘤的临床观察

目的　探讨经尿道双极等离子汽化电切治疗膀胱肿瘤的疗效。方法　运用经尿道双极等离子汽化电切镜治疗膀胱肿瘤 2 7例。结果　手术时间平均 3 0min ,术中出血平均 2 5ml,术后留置导尿管 3～ 5d ,全部患者拔除导尿管后均能自主排尿 ,术中出血少、易操作 ,并发症少。结论　经尿道双极等离子汽化电切膀胱肿瘤安全、可靠。     

双极等离子汽化电切治疗前列腺增生症128例

目的　探讨经尿道双极等离子汽化电切术 (TUVP)治疗前列腺增生症的安全性与有效性。方法　采用经尿道双极等离子汽化电切术切除增生的前列腺 12 8例 ,术后保留三腔F2 2导尿管 3～ 7d ,全部病人随访 1～ 6个月。结果　TUVP手术时间 3 0～ 12 0min ,平均 60min ,术中由于操作失误造成膀胱穿孔 2例 ;12 8例病人拔除导尿管后 ,均能自主排尿 ,110例病人有不同程度的尿急、尿频、尿痛 ;98例病人于术后 1～ 6个月得到随访 ,3例病人前尿道狭窄 ,11例病人出现后尿道狭窄 ,予以杆状电极切开后症状消失 ;无 1例出现经尿道前列腺电切 (TURP)综合征。结论　双极等离子汽化电切治疗前列腺增生症是一种安全、有效的手术方法     

经尿道等离子体双极汽化电切术治疗前列腺增生152例疗效观察

目的探讨经尿道等离子体双极汽化电切术治疗良性前列腺增生的安全性和疗效。方法对我院经尿道等离子双极汽化电切治疗前列腺增生152例患者的临床资料进行分析。结果术中、术后出血少,术中无邻近器官损伤,无电切综合征发生。术后随访6月～1年,排尿困难症状消失140例,8例症状有所改善,3例无变化。最大尿流率由术前平均8.7ml/s上升到术后平均18.9ml/s.IPSS由术前平均24.5分降到术后平均10.5分。假性尿失禁3例,术后括约肌功能锻练2月后,尿控恢复正常。结论经尿道等离子双极汽化电切治疗前列腺增生具有安全性高、并发症少、疗效可靠的优势。     

经尿道前列腺汽化电切术和前列腺等离子电切术的比较

目的评价经尿道前列腺双极等离子电切与前列腺汽化电切在治疗良性前列腺增生症的疗效，探讨汽化电切术与等离子电切术的不同特点。方法选择我院行腔内手术的前列腺患者78例，对手术时间、手术过程、术中冲洗、术中、术后并发症、术后冲洗时间、术后留置尿管时间、术后拔管时间、平均住院时间及拔管后排尿情况的结果进行分析。结果汽化电切组有1例发生前列腺电切综合症（TURS），术后给予静脉输注高渗盐水后治愈。冲洗时间3—5天，留置尿管5—7天，住院时间7-14天，有3例发生术后再出血，其中1例发生在术后1月，术后病检检测出前列腺偶发癌1例，等离子电切组无1例发生前列腺电切综合症（TURS），无1例发生术后再出血，术后留置尿管时间1-3天，住院时间3—5天。术后病检检测出前列腺偶发癌3例；手术时间：汽化电切组平均45—100min，等离子电切组平均45—150min。结论经尿道前列腺双极等离子电切术因为其“冷切割”，热穿透、热损伤效应低加上快速凝血功能及术中用生理盐水冲洗的特点，所以比前列腺汽化电切术在治疗良性前列腺增生症中更安全、更有效。     

经尿道前列腺等离子双极电切与电切术的对照研究

目的比较经尿道前列腺等离子双极电切与电切术治疗良性前列腺增生症的临床效果。方法将我院2010年10月-2011年9月收治的良性前列腺增生症患者102例作为研究对象,电切术治疗的50例患者作为对照组,经尿道前列腺等离子双极电切治疗的52例患者作为观察组,比较两组患者的临床效果。结果观察组患者的膀胱冲洗时间、留置尿管时间及住院时间均明显短于对照组,组间差异均有统计学意义（P〈0．05）;术后两组患者的国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Omax）均有显著改善,但组间差异无统计学意义（P〉0．05）;观察组患者的并发症发生率为1．9％,明显低于对照组的16．0％,组间差异有统计学意义（P〈0．05）。结论经尿道前列腺等离子双极电切与电切术治疗良性前列腺增生症均可以获得满意的临床效果、改善患者生活质量,但经尿道前列腺等离子双极电切有利于患者更快地康复,且安全性上有更大的优势,是临床首选的治疗方案之一。     

两种术式治疗良性前列腺增生的临床观察

目的 对比良性前列腺增生患者应用经尿道双极等离子前列腺剜除术与经尿道双极等离子前列腺电切术治疗的临床效果.方法 采集2019年1月-2020年12月行经尿道双极等离子前列腺剜除术治疗的42例前列腺增生患者临床资料,将其纳入A组;另采集医院同期行经尿道双极等离子前列腺电切术治疗的42例前列腺增生患者临床资料,将其纳入B组.对比两组手术指标、前列腺症状评分(IPSS)以及术后并发症发生情况.结果 与B组相比,A组手术时间、膀胱冲洗时间更短,切除前列腺质量重,差异有统计学意义(P＜0.05);与术前相比,两组术后6个月IPSS评分均降低,且A组降低幅度比B组显著,差异有统计学意义(P＜0.05);与B组相比,A组并发症总发生率低,差异有统计学意义(P＜0.05).结论 经尿道双极等离子前列腺剜除术、经尿道双极等离子前列腺电切术均可将良性前列腺增生患者病变腺体有效切除,但与经尿道双极等离子前列腺电切术相比,经尿道双极等离子前列腺剜除术手术时间及膀胱冲洗时间更短,且术后并发症较少,安全性更高.     

经尿道前列腺双极等离子电切术85例的临床观察

目的：观察经尿道前列腺双极等离子电切术治疗前列腺增生患者的临床效果。方法取收治的85例前列腺增生患者（ BPH）患者为研究对象,所有患者均为良性,均接受经尿道前列腺双极等离子电切术治疗,对本组患者临床资料展开回顾性分析。结果经尿道前列腺双极等离子电切术治疗,患者症状显著改善者计79例,占92.9％;未有显著改善者6例,占7.1％,差异具有统计学意义（ P＜0.05）。结论经尿道前列腺双极等离子电切术治疗效果确切,不受手术时间限制,术野清晰,具有良好的止血效果,同时能够将前列腺病变组织彻底切除。临床可予以推广使用。     

经尿道前列腺等离子汽化电切术并发症的预防与护理

目的 探讨经尿道前列腺等离子汽化电切术治疗良性前列腺增生术后发生的常见并发症,并通过科学的护理措施预防和减少并发症的发生.方法 回顾性分析和总结2005-06~2011-10间的306例良性前列腺增生经尿道等离子电切术后并发症及围手术期的护理经验.结果 通过科学的护理措施可以有效的预防和减少经尿道前列腺等离子汽化电切术后并发症的发生.结论 科学的护理措施是预防和减少经尿道前列腺等离子汽化电切术后并发症发生的关键.     

PKRP、PVP联合PKRP治疗良性前列腺增生的疗效对比分析

目的 研究经尿道绿激光汽化术(photoselective vaporization of the prostate,PVP)联合双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperp...     

经尿道前列腺电汽化术治疗前列腺增生症60列体会

目的:探讨电汽化切割治疗前列腺增生症(BPH)的效果。方法:采用经尿道前列腺电汽化术(TUVP)治疗良性前列腺增生60例。结果:平均手术时间60min;平均出血70ml;最大尿流率由术前5.32±2.35ml/s上升至术后的18.5±3.22ml/s;IPSS症状评分术前28.34±3.12,术后降至8.4±2.12(P〈0.05)。结论:经尿道前列腺电汽化切割出血少,手术安全,治疗效果明显,是治疗BPH最有效的治疗方法之一。有利于在基层广发的开展和普及。     

Embolization for Hemoptysis in Chronic Thromboembolic Pulmonary Hypertension: Report of Two Cases and a Review of the Literature

Hemoptysis is a known complication in patients with bronchial artery hypertrophy due to a variety of chronic pulmonary disorders. Bronchial artery hypertrophy is observed in most patients with chronic thromboembolic pulmonary hypertension (CTEPH), but surprisingly little is known about the incidence of hemoptysis in these patients. In this paper, we report on 2 patients with CTEPH and recurrent severe hemoptysis, who were treated by bronchial artery embolization. One patient recovered and 1 patient died as a consequence of the bleeding. A systematic review revealed 21 studies on the underlying pathology in 1,844 patients with moderate to severe hemoptysis. CTEPH was reported to be the cause of bleeding in 0.1% (n = 2), pulmonary arterial hypertension without chronic thromboembolic disease in 0.2% (n = 4), and acute pulmonary embolism in 0.7% (n = 12) of the patients. In contrast to this, 5 patients (6%) in our own series of 79 CTEPH patients suffered from moderate to severe hemoptysis requiring medical intervention. Severe hemoptysis appears to be an uncommon, but possibly underreported, life-threatening complication in CTEPH patients. As most CTEPH patients require life-long anticoagulants a therapeutic dilemma may ensue. Therefore, we propose that even mild hemoptysis in CTEPH patients warrants prompt evaluation, and treatment by embolization should be offered as first choice in CTEPH patients.     

经尿道前列腺电气化切除术治疗高危前列腺增生症

目的　探讨经尿道电气化切除术治疗高危前列腺增生症的疗效。方法　对 5 8例高危前列腺增生症患者经尿道前列腺电气化切除术的临床资料进行回顾分析。结果　平均手术时间 86min,平均失血量 98ml,平均切割前列腺组织重量 6 8.6 g,术后留置导尿管 3～ 5d ,无电切综合征发生。术后尿流率、剩余尿按国际前列腺症状评分、生活质量评分均明显改善。结论　前列腺增生症合并心、肺、肾疾病或高血压、糖尿病时 ,开放性手术危险性大 ,经尿道电气化切除术为最理想的选择     

选择性激光前列腺汽化术治疗大体积前列腺增生82例的疗效及安全性观察

目的探讨选择性激光前列腺汽化术(PVP)治疗大体积前列腺增生(前列腺体积>100ml)患者的临床效果及安全性。方法回顾性分析82例体积>100ml的前列腺增生患者PVP治疗结果。结果所有患者前列腺平均体积176(110～340)ml,77例手术1次完成,5例手术分两次进行。所有患者术后排尿困难症状明显改善,国际前列腺症状评分(IPSS)由术前平均27.5分降至8.4分,生活质量(QOL)评分由4.6分降至2.1分,最大尿流率(Qmax)由4.9ml/s上升至19.0ml/s,残余尿量(RUV)由350ml降至110ml,均有统计学意义(P<0.01)。结论PVP是治疗体积>100ml前列腺增生患者的一种安全、有效的手术方法。     

老年前列腺疾病的CT诊断（附120例分析）

为了估价ＣＴ对前列腺疾病诊断的价值，笔者对１２０例全部经ＣＴ检查的病例作了研究。有关前列腺大小与年龄的关系，在１２０例中其大小尽管有随年龄增长而有所增大的趋势，但均未超过正常数值范围。１２０例中３６例为前列腺癌，８４例前列腺肥大。ＣＴ表现为密度不均、结节、精囊角变钝或消失；此多见于前列腺癌，亦见于前列腺肥大。然而ＣＴ的复合征象主要见于前列腺癌，只是阳性率相对较少。重要的是ＣＴ对前列腺的良、恶性鉴别是困难的。但对病变的延伸范围及前列腺癌的分期可提供较可靠的依据。     

Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

AIM: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. MATERIALS AND METHODS: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. RESULTS: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. CONCLUSION: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications.     

经尿道前列腺气化切除术后大出血的再手术治疗

目的总结经尿道前列腺气化切除术(TUVP)后大出血的再手术治疗经验。方法回顾性分析2004年1月—2013年6月TUVP术后大出血非手术治疗无效,经再次电切镜下或开放手术治疗的20例患者的临床资料。结果再手术20例中,电切镜下止血17例,术中发现前列腺窝内创面动脉出血10例,静脉出血5例,后尿道渗血1例,未见明显出血点1例。膀胱内探查手术止血3例,术中发现膀胱颈口前列腺窝边缘动脉出血2例,前列腺窝内渗血1例。术后均成功止血,无休克等严重并发症发生。结论前列腺电切术后大出血原因多为止血不彻底所致,非手术治疗无效的大出血应及时在电切镜下止血处理,安全有效,必要时可考虑膀胱内探查,效果确切。     

Diagnostic and prognostic value of serum prostate specific antigen in prostate carcinoma

The upper normal limit of serum prostate specific antigen (PSA) of 4 ng/ml is positively evaluated since it discriminates a large percentage of patients having prostate cancer. The PSA limit of 2.5 ng/ml may be used accordingly for patients younger than 50 years of age. The PSA range of 3.3-4 ng/ml may indicate a percentage of patients positive for prostate carcinoma. The PSA above 10 ng/ml indicates that patients have prostate carcinoma by more than 50 %, which is more than double as compared to patients having PSA limits between 4.1-10 ng/ml. It is important to repeat doubtful PSA tests after 3-4 months. If within a year an increase in PSA of more than 2 ng/ml is detected, a high risk of death from prostate cancer is expected. The time for doubling PSA values within a year is described as "velocity index". As for free PSA, this test is not often applied in many nuclear medicine centers. According to the Mayo Clinic, USA, instructions, when total PSA is 2-3.9 ng/ml and free PSA above 18% of these values, the possibility of prostate cancer is less than 10%. On the contrary, for the above total PSA values, if free PSA is less than 10% of these values, the possibility of prostate cancer increases to more than 30%. It is suggested that PSA values be expressed per g of prostate tissue in order to relate to prostate volume. However, one should have in mind that prostate carcinomas have less PSA per g than hyperthophic glands and their volume is usually larger. There are cases where treatment of prostate hypertrophy with finasteride or treatment of prostate cancer with anticancer drugs, may induce a false low PSA. More information about the practical importance of PSA values is expected after 2 or 3 years when a study by the National Cancer Institute of USA on 74,000 men will be completed.     

NMR scanning of the pelvis: initial experience with a 0.3 T system

Pelvic NMR scans were obtained on 29 patients using a 0.3 T superconducting magnet system. Pathologies studied included four bladder carcinomas, four prostatic carcinomas, four ovarian dermoid cysts, three ovarian cysts, three endometrial carcinomas, two endometriomas, and one each of serous cystadenoma of the ovary, benign prostatic hypertrophy, pelvic hematoma, and undifferentiated sarcoma. NMR is a very promising method for characterizing pelvic masses and in staging pelvic malignancies. It can show primary tumors of the prostate, bladder, and uterus and reveals tumor extension into pelvic fat. The pelvis is particularly well suited to NMR scanning because of the abundant natural contrast provided by pelvic fat and by urine in the bladder and gas in the bowel. There is also less motion blurring than in the upper abdomen and chest because there is relatively little respiratory motion of pelvic organs. Various pulse sequences were used in scanning the pelvis; their relative merits are discussed.     

The evaluation of gross hematuria in anticoagulated patients: efficacy of i.v. urography and cystoscopy

To determine the efficacy of investigating gross hematuria in anticoagulated patients, records were reviewed of 24 patients who had gross hematuria while being treated with warfarin for various thromboembolic disorders. All had IV urography, and half had cystoscopy. Sources of bleeding were found in seven (29%) of 24 patients by IV urography and in five (42%) of 12 patients by cystoscopy. Abnormalities considered responsible for bleeding included renal stones (four), transitional cell carcinoma (one), calcified renal mass (one), lymphoma (one), bladder tumors (two), hemorrhagic cystitis (two), and a bleeding prostate tumor (one). Additionally, an enlarged prostate was the only abnormal finding in five patients. If an enlarged prostate is considered a source of bleeding, the workup that included both IV urography and cystoscopy identified a cause of bleeding in 17 (71%) of 24 patients. The results suggest that IV urography and cystography are warranted in patients who take anticoagulants and who have gross hematuria.