TUEB剜除电极下经尿道等离子前列腺剜除术的安全性及有效性研究

目的:研究TUEB剜除电极下经尿道等离子前列腺剜除术(TUEP)的安全性及有效性。方法:收集2011年5月~2011年9月我院因中、重度下尿路症状诊断为前列腺增生(BPH)具备手术指征,行TUEB剜除电极下的TUEP术的56例患者的临床资料。监测术前经腹超声前列腺重量,血清前列腺特异抗原(PSA);术中出血量,前列腺切除率,术后血红蛋白,血钠浓度,血葡萄糖浓度;术前、术后1个月及3个月的国际前列腺症状评分(IPSS),生活质量评分(QOL),最大尿流率(Qmax),剩余尿量(RUV)(经腹超声)及术后并发症发生率等指标。结果:43例患者完成3个月随访,前列腺切除率(64.18±7.54)%,单位时间切除量(0.89±0.36)g,患者无电切综合征及包膜穿孔,血糖、血钠浓度手术前后差异无统计学意义。术后1个月IPSS评分、QOL评分、Qmax及RUV较术前显著好转。术后1个月及术后3个月上述指标差异无统计学意义。术后短暂性尿失禁发生率7.14%,恢复时间(4.50±1.29)d,无永久性尿失禁,术后1个月尿道狭窄发生率16.07%,尿道扩张后均缓解。结论:TUEB剜除电极下TUEP术是安全有效的手术方法。

The safety and effectiveness of transurethral enucleation of prostate with enucleation electrode of TUEB

Objective：To investigate the safety and efficacy of transurethral enucleation of the prostate with enucleation electrode of TUEB.Method：From May 2011to Sep 2011,56cases diagnosed benign prostatic hyperplasia（BPH）in our department who received TUEP with TUEB enucleation electrode,were invited to participate in the trial.Bleeding,resection rate were recorded during the operation.After the operation,hemoglobin,blood glucose and occurrence of urinary incontinence and some other complications after removal of catheter were tested.1and 3months postoperatively,International Prostate Symptom Score（IPSS）,Quality of Life（QOL）,maximum urine flow rate（Qmax）and residual urine volume（RUV）were tested.Result：43patients were followed up in 3months.Prostate resection rate of study group was（64.18±7.54）%,average resection weight per unit time（0.89±0.36）g.No TURS or capsule perforation occurred.There was no statistically significant difference in serum sodium and blood glucose before and after operation.1month after the operation,IPSS,QOL,Q maxand RUV were better than those in preoperation（P〈0.01）.There were no statistically significant differences in IPSS QOL QmaxRUV 1month and 3months postoperatively.7.14%patients had provisionality incontinence and all cases were recovery in（4.50±1.29）d.There is no permanent urinary incontinence.Conclusion：TUEP with monopolar is a safe and effective method of transurethral resection of the prostate.