经尿道等离子双极电切治疗高危良性前列腺增生

目的探讨经尿道双极等离子电切术（PKRP）治疗高危良性前列腺增生（BPH）的临床效果和安全性。方法回顾性分析经尿道双极等离子电切术治疗159例高危BPH患者的疗效。结果159例患者均1次顺利完成手术,无经尿道前列腺电切术（TURP）综合征及闭孔神经反射发生,PKRP手术时间平均45（s=23）min,切除前列腺组织质量平均30（s=28）g。出血量平均43（s=32）mL,术后48 h内拔除尿管,排尿均通畅。术后1、3、6、12个月,最大尿流率（Qmax）由术前的平均4.9（s=4.1）mL/s分别上升至17.6（s=4.5）、20.6（s=4.7）、21.3（s=5.5）、22.4（s=5.3）mL/s;国际前列腺症状评分（IPSS）由术前的平均23.7（s=3.28）分别下降至7.1（s=2.21）、6.3（s=2.15）、6.0（s=2.03）、5.6（s=2.00）;生活质量评分术后均下降（P均〈0.05）。平均随访8（6-12）个月,尿道狭窄1例,暂时性尿失禁11例。无1例发生真性尿失禁。结论等离子双极电切行经尿道前列腺切除是一种安全、有效的手术方式,其操作方式、切除速度与传统TUR手术相似,而且具有止血效果好、使用生理盐水为冲洗液、无须负极板、手术创伤轻,并发症少等优点,可推广应用于高危前列腺增生症患者。

Transurethral resection of high-risk benign prostatic hyperplasia using bipolar plasmakinetic technique

Objective To assess the clinical efficacy and safety of transurethral resection of the prostate(PKRP)with plasmakinetic technique.Methods A total of 159 patients with high-risk benign prostatic hyperplasia(BPH) and being treated by PKRP were analyzed retrospectively.Results The duration of the PKRP procedure was 45(s=23) min.No transurethral resection(TURP) syndrome and abjuratory reflex occurred.The volume of intraoperative bleeding was 43(s=32) mL.Peak urine flow increased from 4.9(s=4.1) mL/s to 17.6(s=4.5) mL/s,P<0.05,and IPSS decreased from 23.7(s=3.28) to 6.3(s=2.15,P<0.01,in 3 months postoperatively.No residual urine occurred after the operation.Conclusions PKRP is effective and safe with less complication.It can be extend to cure high-risk hyperplasia of prostate.