• 涼山州第二人民醫(yī)院泌尿外科（四川西昌，615000）;

【摘要】　目的　 探討采用不同方法經(jīng)尿道前列腺等離子雙極電切術(shù)（plasmakinetic resection of prostate，PKRP）的方法及療效。　方法　 2008年7月-2009年12月，應(yīng)用不同方法行PKRP治療156例前列腺增生?；颊吣挲g59~87歲，平均74歲。病程20 d~18年。前列腺重量22~100 g，平均38 g。采用單純順行電切法治療38例，部分剜除分割切除法治療76例，完全剜除法治療42例。　結(jié)果　 156例手術(shù)均獲成功，手術(shù)時(shí)間平均90 min。獲得前列腺組織12~87 g，平均35 g。術(shù)后留置導(dǎo)尿管平均5.5 d，住院時(shí)間平均6.5 d。術(shù)后組織病理學(xué)診斷為良性前列腺增生152例，前列腺癌4例。拔除尿管后均能自主排尿，部分患者術(shù)后有尿道刺激癥狀；術(shù)后1個(gè)月內(nèi)出現(xiàn)尿道外口狹窄3例，經(jīng)尿道擴(kuò)張治愈。隨訪時(shí)間1~12個(gè)月，平均6個(gè)月。短期尿失禁3例，時(shí)間分別為1周、1個(gè)月及3個(gè)月；無長期尿失禁。術(shù)后3個(gè)月國際前列腺癥狀評(píng)分（IPSS）癥狀評(píng)分平均減少24分，生活質(zhì)量評(píng)分平均減少3分。　結(jié)論　 PKRP安全、有效、并發(fā)癥少，可針對(duì)患者情況采用不同切割方法，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.

引用本文： 何秉勛,朱衛(wèi)國. 不同方法經(jīng)尿道前列腺等離子雙極電切術(shù). 華西醫(yī)學(xué), 2011, 26(2): 204-206. doi: 復(fù)制

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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.
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8. 　鄭少波, 劉春曉, 徐亞文, 等. 腔內(nèi)剜除法在經(jīng)尿道前列腺汽化電切術(shù)中的應(yīng)用[J]. 中華泌尿外科雜志, 2005, 26(8): 558-561.
9. 　朱衛(wèi)國, 何秉勛, 歐陽波. 經(jīng)尿道單極電切剜除法治療前列腺增生[J]. 華西醫(yī)學(xué), 2009, 24(1): 101-102.
  1. 1. 　那彥群. 中國泌尿外科疾病診斷治療指南[M]. 北京: 人民衛(wèi)生出版社, 2007: 167-204.
  2. 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. 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. 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. 5. 　平岡保紀(jì). 前立腺肥大癥に對(duì)する新しい治療法[J]. 日本醫(yī)事新報(bào), 1993, 3583: 15-19.
  6. 6. 　余良, 劉春曉, 張鳳林, 等. 經(jīng)尿道雙極氣化治療前列腺增生的療效觀察(附50例報(bào)告)[J]. 臨床泌尿外科雜志, 2001, 16(10): 450-452.
  7. 7. 　陳向東, 張順興, 陸洪兵. 應(yīng)用Gyrus等離子體切割系統(tǒng)經(jīng)尿道前列腺剜除術(shù)(附75 例報(bào)告)[J]. 中國男科學(xué)雜志, 2003, 17(4): 247-249.
  8. 8. 　鄭少波, 劉春曉, 徐亞文, 等. 腔內(nèi)剜除法在經(jīng)尿道前列腺汽化電切術(shù)中的應(yīng)用[J]. 中華泌尿外科雜志, 2005, 26(8): 558-561.
  9. 9. 　朱衛(wèi)國, 何秉勛, 歐陽波. 經(jīng)尿道單極電切剜除法治療前列腺增生[J]. 華西醫(yī)學(xué), 2009, 24(1): 101-102.