摘要
目的 探讨经皮膀胱穿刺造瘘在经尿道前列腺等离子电切术（PKRP）治疗高危高龄大体积前列腺增生中的临床价值.方法 2012年1月～ 2013年6月35例行前列腺电切的高龄高危前列腺增生患者随机数字表法分为造瘘组和非造瘘组,分别采用经皮膀胱造瘘＋ PKRP和标准PKRP.监测术中血压（MBP）、心率（HR）、中心静脉压（CVP）,检测术前、术后血酸碱度（pH）、Na^＋、K^＋、Cl^-、阴离子间隙（BE）,记录手术时间、术中出血量、切除前列腺质量、术后尿色转清时间,评估手术前后的IPSS、最大尿流率、残余尿量（PVR）和生活质量评分（QOL）.结果 非造瘘组术中MBP、CVP较术前差异有统计学意义（P＜0.05）,造瘘组术中MBP、HR、CVP较术前差异无统计学意义.非造瘘组Na^＋、pH、BE术前术后差异有统计学意义（P＜0.05）,造瘘组Na^＋、K^＋、Cl^-、pH、BE术前术后差异无统计学意义,提示造瘘组较非造瘘组更安全.造瘘组较非造瘘组手术时间更长、前列腺切除质量更多,术后尿色转清时间更短,最大尿流率、IPSS改善更佳,提示造瘘组较非造瘘组治疗效果更佳.结论 经皮膀胱造瘘安全、微创,联合PKRP治疗高龄高危BPH提高了手术的安全性,增加了手术的治疗效果,值得临床应用推广.
Objectives To investigate the safety and efficacy of combination regimen of PKRP and cystostomy for BPH patients at high risk.Methods 35 BPH patients at high risk were randomly divided into two groups：Cystostomy group and non-cystostomy group.The patients in the non-cystostomy group underwent PKRP,The patients in the cystostomy group received combination regimen of PKRP and cystostomy.Mean blood pressure （MBP）,heart rate（HR）,central venous pressure（CVP） were monitored during operation.Serum pH,Na ^＋,K ＋,Cl^-,anion gap（BE） were determined before and after operation.The operation time,intraoperative bleeding volume,resection of the prostate quality,postoperative urine turned clear time were recorded.IPSS,maximum flow rate （Qmax）,postvoid residual volume （PVR）,life quality score （QOL） was evaluated before and after operation.Results MBP,HR,CVP,Na^ ＋,K^ ＋,Cl^-,pH,BE did not change significantly during and after operation in the cystostomy group.MBP,CVP,Na ＋,pH,BE change significantly in the non-cystostomy group（P 〈 0.05）.Compared with the non-cystostomy group,the cystostomy group underwent longer duration of operation （P 〈 0.05）,quantity of resected tissue more（P 〈0.05）,postoperative urine turned clear time shorter（P 〈 0.05）,the Qmax and IPSS were more improved.Conclusions Percutaneous cystostomy safe,minimally invasive,combined with PKRP in the treatment of high-risk BPH improves the operation safety,increase the operation therapeutic effect,is worthy of clinical application and promotion.
出处
《国际泌尿系统杂志》
2014年第3期328-331,共4页
International Journal of Urology and Nephrology
关键词
前列腺增生
膀胱
穿刺术
电外科手术
Prostatic Hyperplasia
Urinary Bladder
Punctrues
Electrosurgery
