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目的 探讨经尿道前列腺电气化术 ( TVP)术中及术后的常见并发症及产生原因 ,以提高 TVP治疗效果。方法 对 1 80例有症状的良性前列腺增生 ( BPH)患者行 TVP术。平均年龄 71岁 ,术后随访 1~ 6个月。结果 术中和术后共发生并发症 2 1例次 ( 1 1 .7% ) ,其中前列腺包膜穿孔 3例 ( 1 .7% ) ,膀胱穿孔 1例 ( 0 .6 % ) ,经尿道电切综合征 ( TURS) 3例 ( 1 .7% ) ,继发性出血 2例 ( 1 .1 % ) ,尿道狭窄 4例 ( 2 .2 % ) ,暂时性尿失禁 5例 ( 2 .8% ) ,置管困难 1例 ( 0 .6 % ) ,再次置管 2例 ( 1 .1 % ) ,无真性尿失禁和死亡病例。结论 TURS的发生多继发于包膜穿孔 ,术中连续监测血糖可及时发现 TURS先兆 ;术后膀胱痉挛、便秘 ,尿路感染是继发性出血的重要原因 ;术中操作轻柔、选择适宜的导尿管可以减少尿道狭窄的发生
Objective To explore the common complications and causes of postoperative transurethral electrovaporization of prostate (TVP) in order to improve the therapeutic effect of TVP. Methods One hundred and eighty patients with symptomatic benign prostatic hyperplasia (BPH) underwent TVP. The average age was 71 years and was followed up for 1 to 6 months. Results A total of 21 cases (11.7%) had complications during and after operation, including 3 cases of prostatic capsule perforation (1.7%), 1 case of bladder perforation (0.6%), Three cases of TURS (1.7%), 2 cases of secondary bleeding (1.1%), 4 cases of urethral stricture (2.2%), 5 cases of temporary urinary incontinence (2.8% ), 1 case (0.6%) had difficulty in catheterization, 2 cases (1 .1%) re-catheterized, and no cases of true urinary incontinence and death. Conclusions The occurrence of TURS is mostly secondary to perforation of the capsule. Continuous monitoring of blood glucose in the operation can detect TURS in time. Postoperative bladder spasm, constipation and urinary tract infection are the major causes of secondary hemorrhage. The operation is gentle and appropriate Catheter can reduce the occurrence of urethral stricture