Application of Various Methods of Transurethral Plasmakinetic Resection of Prostate_West China Medical Journal

Authors：

HE Bingxun , ZHU Weiguo

Department of Urology,The Second Hospital of Liangshan,Xichang,Sichuan,615000,P.R.China;

Corresponding author：

Keywords：

前列腺增生; 经尿道前列腺切除; 双极等离子电切术

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【摘要】　目的　探讨采用不同方法经尿道前列腺等离子双极电切术（plasmakinetic resection of prostate，PKRP）的方法及疗效。　方法　 2008年7月-2009年12月，应用不同方法行PKRP治疗156例前列腺增生。患者年龄59~87岁，平均74岁。病程20 d~18年。前列腺重量22~100 g，平均38 g。采用单纯顺行电切法治疗38例，部分剜除分割切除法治疗76例，完全剜除法治疗42例。　结果　 156例手术均获成功，手术时间平均90 min。获得前列腺组织12~87 g，平均35 g。术后留置导尿管平均5.5 d，住院时间平均6.5 d。术后组织病理学诊断为良性前列腺增生152例，前列腺癌4例。拔除尿管后均能自主排尿，部分患者术后有尿道刺激症状；术后1个月内出现尿道外口狭窄3例，经尿道扩张治愈。随访时间1~12个月，平均6个月。短期尿失禁3例，时间分别为1周、1个月及3个月；无长期尿失禁。术后3个月国际前列腺症状评分（IPSS）症状评分平均减少24分，生活质量评分平均减少3分。　结论　 PKRP安全、有效、并发症少，可针对患者情况采用不同切割方法，效果更佳。
【Abstract】　Objective　 To explore the effects and methods of transurethral plasmakinetic resection of prostate(PKRP).　Methods　 A total of 156 patients with prostatic hyperplasia were treated with various methods of transurethral PKRP from July 2008 to December 2009. Patient’s age ranged from 59 to 87 years,74 years on average. The disease duration was 20 days to 18 years.Method one:anterograde resection in 38 patients; method two:partition retrograde enucleation in 76 patients; method three:completely retrograde enucleation in 42 patients.　Results　 All of the swgeries were successful. The mean duration of the operation was 90 minutes.The collected prostatic specimens were 12-87 g,35 g on average. The mean catheter remaining dwation was 5.5 days.The mean postoperative hospital stay was 6.5 days.　Conclusions　 PKRP is safe and effective. It is effective with various methods of transurethral plasmakinetic resection of prostate.

Citation： HE Bingxun,ZHU Weiguo. Application of Various Methods of Transurethral Plasmakinetic Resection of Prostate. West China Medical Journal, 2011, 26(2): 204-206. doi: Copy

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1. 　那彦群. 中国泌尿外科疾病诊断治疗指南[M]. 北京: 人民卫生出版社, 2007: 167-204.
2. 　Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate(TURP)-incidence,management, and prevention[J]. Eur Urol, 2006, 50(5): 969-979.
3. 　Hon NH, Brathwaite D, Hussain Z, et al. A prospective,randomized trial comparing conventional transurethral prostate resection with plasmakinetic vaporization of the prostate:physiological changes,early complications and long-term followup[J]. J Urol, 2006, 176(1): 205-209.
4. 　Page BH. The pathological anatomy of digital enucleation for bening prostatic hyperplasia and its application to endoscopic resection[J]. Br J Urol, 1980, 52(2): 111-126.
5. 　平冈保纪. 前立腺肥大症に对する新しい治疗法[J]. 日本医事新报, 1993, 3583: 15-19.
6. 　余良, 刘春晓, 张凤林, 等. 经尿道双极气化治疗前列腺增生的疗效观察(附50例报告)[J]. 临床泌尿外科杂志, 2001, 16(10): 450-452.
7. 　陈向东, 张顺兴, 陆洪兵. 应用Gyrus等离子体切割系统经尿道前列腺剜除术(附75 例报告)[J]. 中国男科学杂志, 2003, 17(4): 247-249.
8. 　郑少波, 刘春晓, 徐亚文, 等. 腔内剜除法在经尿道前列腺汽化电切术中的应用[J]. 中华泌尿外科杂志, 2005, 26(8): 558-561.
9. 　朱卫国, 何秉勋, 欧阳波. 经尿道单极电切剜除法治疗前列腺增生[J]. 华西医学, 2009, 24(1): 101-102.

West China Medical Journal

Application of Various Methods of Transurethral Plasmakinetic Resection of Prostate

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