改良Nesbit法经尿道前列腺电切术治疗高危良性前列腺增生症疗效分析

目的探讨改良Nesbit法行经尿道前列腺电切术（TURP）治疗高危良性前列腺增生症的临床疗效。方法选取76例高危良性前列腺增生症患者，其中采用Nesbit法行TURP术治疗37例（Nesbit组），改良Nesbit法行TURP术治疗39例（改良Nesbit组），分别对两组患者手术前后国际前列腺症状评分（I-PSS）、生活质量评分（QOL）、最大尿流率（Qmax）、手术时间、切除腺体重量、术中出血量、术后膀胱冲洗时间、手术并发症、术后住院时间等进行比较和分析。结果所有患者手术均成功，无大出血及前列腺电切综合征发生，两组患者术后I-PSS、QOL、Qmax均较术前明显改善（P〈0.05），但两组间差异并不明显（P〉0．05）;改良Nesbit组手术时间、膀胱冲洗时间、住院时间均显著低于Nesbit组（均P〈0．01），术中出血量、并发症发生率均明显低于Nesbit组（均P〈0．05）。结论应用个体化围手术期处理，择期行改良Nesbit法TURP治疗高危良性前列腺增生症，具有手术时间短、术中出血量少、术后恢复快等优点，是一种安全、有效的手术方法。

Transurethral resection of prostate by modified Nesbit's method in treatment of high-risk benign prostate hyperplasia

Objective To evaluate the efficacy of transurethral resection of prostate （TURP） by modified Nesbit＇s method for high-risk benign prostate hyperplasia （BPH）. Methods Seventy six patients with high-risk BPH who underwent TURP were divided into 2 groups： 37 cases by Nesbit＇s method and 39 cases by modified Nesbit＇s method. International prostate symptom score （I-PSS）,quality of life score （QOLS）, residual urine volume （RUV）, operative time, blood loss during operation,the weights of dissected prostate tissue, postoperative bladder irrigation time, postoperative complications and the length of hospital stay were assessed in both groups. Results The successful rate of operation was 100% in both group and no TURS occurred. There were statistical differences in Qmax, RUV, I-PSS and QOL before and after operation （P〈0.05）. The operative time, bladder irrigation time and length of hospital stay were shorter in modified group; blood loss during operation and postoperative complications were less （P〈0.05）. Conclusion TURP by modified Nesbit＇s method is a safe and effective method for high-risk BPH with less operative time, less blood loss during operation, less postoperative complications.