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目的 :探讨经尿道前列腺切除 (TURP)治疗重度前列腺增生症 (BPH)的可行性。方法 :采用TURP治疗重度的BPH 378例。前列腺平均重量 73.8g。膀胱灌洗压力 5 0～ 6 0cmH2 O ,平均流量 2 5 0～ 35 0ml/min。术中血电解质监测 ,血钠降低 10mmol/L ,肌注速尿 2 0mg。结果 :平均手术时间 132min。前列腺组织的平均去除率 75 .3%。发生经尿道切除综合征 (TURS) 1例 (0 .2 6 % )。术后排尿通畅率为 10 0 %。 3个月后最大尿流率由术前 (5 .9± 2 .5 )ml/s升至 (2 2 .6± 7.3)ml/s(P <0 .0 1)。术后随访 ,生活质量 (QOL)良好者 95 .6 %。结论 :术中低压、低流量膀胱灌洗 ,监测血电解质变化 ,及时治疗低钠血症 ,增加手术时间 ,TURP治疗重度BPH是安全、可行的。
Objective: To investigate the feasibility of transurethral resection of the prostate (TURP) for the treatment of severe benign prostatic hyperplasia (BPH). Methods: 378 cases of severe BPH were treated with TURP. The average prostate weight 73.8g. Bladder lavage pressure 5 0 ~ 60cmH2O, the average flow of 250 ~ 35 0ml / min. Intraoperative blood electrolyte monitoring, serum sodium decreased 10mmol / L, intramuscular furosemide 20mg. Results: The average operation time was 132min. The average removal rate of prostate tissue was 75.3%. Transurethral resection syndrome (TURS) occurred in 1 case (0.26%). Postoperative voiding patency rate was 100%. After 3 months, the maximum urinary flow increased from (5.9 ± 2.5) ml / s to (22.6 ± 7.3) ml / s preoperatively (P <0.01). After follow-up, 95.6% of the patients had good quality of life (QOL). Conclusion: Intraoperative low pressure, low flow bladder lavage, blood electrolyte monitoring changes, timely treatment of hyponatremia, increase the operation time, TURP treatment of severe BPH is safe and feasible.