目的 探讨前列腺体积＞60 mL的前列腺增生症患者的手术安全性，提高部分合并尿道狭窄前列腺增生症患者的手术实施率。 方法 2009年3月－2010年3月，行耻骨上膀胱穿刺引流下经尿道前列腺电切术（TURP）治疗前列腺增生58例。年龄54～93岁，平均72岁，病程8个月～12年，平均7.2年；前列腺体积35～128 mL，平均78 mL；国际前列腺症状评分24～35分，平均30.2分 ；最大尿流率1.2～4.8 mL/s，平均1.8 mL/s；残余尿量84～210 mL，平均160 mL。术前无尿潴留28例。 结果 58例顺利完成手术，其中2例伴包膜穿孔，9例前尿道狭窄者通过去外鞘电切镜完成手术。所有患者切除前列腺组织体积18～86 mL，平均58 mL；术中冲洗液为5%葡萄糖液，用量18 600～42 500 mL，平均23 500 mL；手术时间45～185 min，平均70 min。术后病理检查均示良性前列腺增生，术后住院时间3～8 d，平均5 d。术后患者最大尿流率为18～46 mL/s，平均32 mL/s。 结论 耻骨上膀胱穿刺引流能降低膀胱内压，减少水、糖分吸收，增加手术安全性，提高了部分合并前尿道狭窄的前列腺增生患者的手术几率。
目的:探讨经尿道前列腺电切术(TURP)治疗高危良性前列腺增生症(BPH)的术中、术后常见并发症的原因、预防及治疗,提高手术安全性和有效性。方法: 回顾性分析62例高龄合并心肺疾患的前列腺增生症患者行经尿道前列腺电切术(TURP)的临床资料。结果: 62例排尿困难症状均改善,其中1例出现暂时性尿失禁,2月后好转,尿路感染7例,消炎治疗后好转,5例出现肉眼血尿,做对症处理后血尿消失,无输血病例,无经尿道电切综合征(TURS)发生。结论:采用TURP是良性前列腺增生症安全有效的外科治疗方法,疗效满意,并发症少,安全性高,住院时间短,费用低。
目的 比较经尿道前列腺剜除术（TUEP）与经尿道前列腺电切术（TURP）的疗效。 方法 2010年11月－2011年3月，收治前列腺增生（BPH）患者58例，分别采用TUEP（30例）、TURP（28例）治疗。患者年龄55～87岁，平均73岁；病程1～12年，平均5年。术前常规行直肠指检前列腺光滑无结节；经直肠前列腺彩色超声多普勒检查，测得前列腺体积为50～80 mL，平均62 mL；血清前列腺特异性抗原＜10 ng/mL。 结果 TUEP组术中出血量、术后冲洗时间均短于TURP，切除前列腺组织体积大于TURP组，差异均有统计学意义（P＜0.05）。术后拔除尿管后发生暂时性尿失禁TUEP组1例，TURP组发生2例，两组比较差异无统计学意义；两组均无永久性尿失禁发生。 结论 TUEP与TURP相比较，TUEP手术疗效好，出血少、恢复快，且并发症少。
摘要:目的:探讨经尿道前列腺电切术中糖尿病患者血糖变化以及处理对策。方法:2006年7月~ 2009年1月共对80例患有前列腺增生合并糖尿病患者行TURP,同期对80例单纯性前列腺增生患者进行相同手术,回顾分析其术前、术中30 min、60 min、90 min 指尖血糖变化及干预情况。结果:治疗组80例患者,51例术中血糖值明显低于术前,分别为1.8～3 mmol/L;对照组术前与术中血糖值基本一致,血糖波动于4.5～5.6 mmol/L。结论:糖尿病患者糖的储备能力差,在行经尿道电切术中易发生低血糖综合征,术中及时的血糖监测及干预对保证患者的安全有重要意义。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
【摘要】 目的 探讨良性前列腺增生（benign prostatic hyperplasia，BPH）伴膀胱结石的有效腔内治疗方法。〖HTH〗方法 2003年6月-2009年12月，使用F26号电切镜外鞘作为撑开器，气压弹道和（或）钬激光粉碎膀胱结石，经尿道前列腺电切术 （transurethral resection of the prostate，TURP） 治疗BPH伴膀胱结石86例。患者年龄58～83岁，平均68.6岁；病程2～8年，平均5.2年。术前患者国际前列腺症状评分（international prostate symptom score，IPSS）为（24.6±3.9）分，生活质量（5.7±0.6）分；前列腺重量（46.5±6.8） g，剩余尿量（185±58） mL，最大尿流率（5.7±2.3） mL/s。 结果 86例均一次手术成功。碎石时间为16~58 min，平均38 min；前列腺电切时间40~100 min，平均65 min。术中无并发症发生。术后 5~8 d拔除尿管，平均6.5 d。术后4 例出现前尿道狭窄，经治疗后痊愈。54例获随访，随访时间2~6个月，平均3个月。术后2个月，54例最大尿流率升至（18.5±4.1） mL/s，剩余尿量下降至（16±22） mL，IPSS评分下降至（7.8±1.6）分，生活质量（2.5±0.3）分，与术前比较差异均有统计学意义（Plt;0.01）。 结论 经尿道碎石术和TURP一次性治疗BPH伴膀胱结石安全、有效、经济。【Abstract】 Objective To explore an effective endourologic treatment method for benign prostatic hyperplasia (BPH) with bladder calculi. Methods From June 2003 to December 2009, ballistic or holmium laser lithotripsy by outer sheath resectoscope and transurethral resection of the prostate (TURP) were performed on 86 patients with BPH and bladder calculi. The patients aged 58 to 83 years old, averaging at 68.6 years. Duration of their disease course ranged from 2 to 8 years, averaging 5.2 years. Before surgery, the international prostate symptom score (IPSS) was 24.6±3.9; the score of quality of life (QOL) was 5.7±0.6; prostatic weight was (46.5±6.8) g; residual urine (RU) volume was (185±58) mL; and the peak urine flow rate (Qmax) was (5.7±2.3) mL/s. Results The operations were completed successfully in all cases with a mean lithotripsy time of 38 min (16-58 minutes) and a mean TURP time of 65 min (40-100 minutes). No complications occurred during the operation. Urethral catheter was withdrawn 5-8 days after operation, with a mean period of 6.5 days. Four patients had anterior urethral stricture after operation, but recovered through treatment. Fifty-four patients were followed up for 2 to 6 months with an average follow-up time of 3 months. Two months after the operations, IPSS decreased to 7.8±1.6; Qmax increased to (18.5±4.1) mL/s; RU decreased to (16±22) mL and QOL was 2.5±0.3. Compared with preoperative conditions, the differences were all statistically significant (P＜0. 01). Conclusion Transurethral lithotripsy combined with TURP is an effective, safe and economical treatment for benign prostatic hyperplasia with bladder calculi.
Objective To assess the effectiveness and safety of YunNan BaiYao capsules in reducing bleeding quantity during TURP. Methods A double-blind randomized controlled trial was conducted. We randomly allocated 40 patients to the treatment group （ YunNan BaiYao 0.25 g capsule, 2 capsules, q. i. d. , n = 20 ） and the control group （starch capsule, 2 capsules, q. i. d. , n =20）. Patients in both groups were administered three days before operation. Average bleeding quantity, bleeding index of prostate, bleeding intension, length of stay, catheter retention time, and time of washing bladder were observed and compared. Results The average bleeding quantity, bleeding index of prostate and bleeding intension were better in the treatment group than that of the control group with significant difference （P 〈0. 05 ）. The length of stay, catheter retention time and time of washing bladder had no significant difference between the two groups （P 〉0.05）. No obvious adverse effect was observed in both groups. Conclusions YunNan BaiYao capsule can effectively reduce bleeding quantity during TURP without obvious adverse effects.
ObjectivesTo systematically evaluate the efficacy and safety of 1 470 nm laser vaporization vs. transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) about the efficacy and safety of 1 470 nm laser vaporization vs. TURP for BPH from inception to October 22nd, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 6 RCTs and 4 non-RCTs were included. The results of meta-analysis showed that: 1 470 nm laser vaporization was superior to TURP in reducing intraoperative bleeding (MD=−103.87, 95%CI −148.08 to −59.65, P<0.000 01), hospital stay (MD=−3.82, 95%CI −4.35 to −3.28, P<0.000 01), postoperative indwelling catheter time (MD=−2.24, 95%CI −3.45 to −1.02, P=0.000 3), postoperative hemoglobin (MD=−1.63, 95%CI −3.14 to −0.12, P=0.03) and rate of secondary hemorrhage (OR=0.13, 95%CI 0.03 to 0.48, P=0.002). There were no significant differences in operative time, bladder irrigation time, transient urinary incontinence and urethral stricture, IPSS Score and Qmax at 3 months after operation between the two groups (P>0.05).ConclusionCurrent evidence shows that 1 470 nm laser vaporization is superior to TURP in reducing intraoperative bleeding and secondary hemorrhage. It may be more suitable for prostate surgery in anticoagulant or coagulative dysfunction patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo explore the effect of clinical nursing pathway on rehabilitation indicators in patients who had undergone transurethral resection of prostate (TURP). MethodsA total of 241 patients underwent TURP between July 2010 and March 2014 were randomly divided into path group (121 cases) and control group (120 cases). The nursing results of the two groups were observed. ResultsThe complication rate of bladder spasm, secondary hemorrhage, urethral stricture in path group were lower than those in the control group with significant differences (P<0.05). ConclusionThe performance of clinical nursing pathway on TURP patients may reduce the complications rate, and promote the health economics indicators and quality of care.