经尿道整体剜除与经尿道前列腺切除术治疗大体积前列腺增生的比较分析

发布时间：2018-02-10 11:36

本文关键词： 前列腺增生症大体积整体剜除手术刨削器　出处：《中国内镜杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨经尿道剜除联合手术刨削器治疗大体积(80 ml)前列腺增生症(BPH)的临床效果。方法回顾性分析2014年2月-2016年2月65例大体积BPH,按手术方法分为两组,剜除组和电切组,剜除组30例,采用经尿道腔内整体剜除前列腺,完整剜除后推入膀胱,更换手术刨削器,将剜除的腺体粉碎取出;电切组35例,采用常规经尿道前列腺等离子电切术(TURP)。结果 65例均顺利完成手术。剜除组手术时间较TURP组短[(48.5±17.3)vs(75.6±21.4)min,t=5.55,P=0.000],术中出血量较TURP组少[(51.8±14.6)vs(102.3±32.4)ml,t=7.87,P=0.000]。腺体切除体积较TURP组多[(78.3±15.5)vs(61.8±12.9)ml,t=4.69,P=0.000]。两组术后膀胱冲洗时间和术后住院天数相比较,差异无统计学意义(P0.05)。剜除组术后暂时性尿失禁比例高于电切组(8/30 vs 4/35)。两组术后3个月国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和残余尿均较术前明显改善(P0.05),但两组间差异无统计学意义(P0.05)。结论经尿道腔内整体剜除联合手术刨削器治疗大体积BPH,手术时间更短,术中出血量少,切除腺体更彻底。
[Abstract]:Objective to investigate the clinical effect of transurethral enucleation combined with surgical planer in the treatment of massive prostatic hyperplasia (BPH). Methods 65 cases of BPH from February 2014 to February 2016 were retrospectively analyzed and divided into two groups according to the operative methods: gouging out group and electric resection group. 30 cases in the gouging group were treated with transurethral total enucleation of prostate, and after complete enucleation, the bladder was pushed into the bladder, the surgical planer was replaced, and the gouged glands were crushed and removed, while in the electroresection group, 35 cases were treated with transurethral resection. Routine transurethral resection of the prostate was performed by transurethral plasma resection of the prostate (TURP). Results 65 cases were successfully performed. The operation time in the gouge removal group was shorter than that in the TURP group [48.5 卤17.3v / s 75.6 卤21.4min vs 5.5min P 0.000], and the intraoperative bleeding volume was less than that in the TURP group [51.8 卤14.6vs102.3 卤32.4ml / 7.87p 0.000]. The volume of glandectomy was much longer than that in the TURP group [78.3 卤15.5vs 61.8 卤12.9ml / t 4.69P0. 000]. After operation, the volume of glandectomy in the two groups was higher than that in the TURP group (78.3 卤15.5vs 61.8 卤12.9ml / min P0.000). The washing time was compared with the days of hospitalization after operation. The proportion of temporary urinary incontinence in the gouge removal group was higher than that in the electroresection group (8 / 30 vs 4 / 35). The international prostatic symptom score (IPSS) and the maximal urinary flow rate (Qmaxmax) and residual urine in the two groups were significantly improved 3 months after operation compared with those before operation (P 0.05), but there was no significant difference between the two groups. Conclusion the total enucleation of transurethral cavity combined with surgical planer in the treatment of large volume of BPH is much shorter. Less intraoperative bleeding and more complete removal of glands.
【作者单位】：新疆军区乌鲁木齐总医院泌尿外科;
【分类号】：R699.8

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