CAJ | 학술논문

目的探讨良性前列腺增生(BPH)经尿道前列腺电切(TURP)术中包膜穿孔的原因及防治措施.方法对2002年2月至2011年2月行TURP术的893例患者的临床资料进行回顾性分析.结果 893例患者中,并发包膜穿孔16例,有覆盖的穿孔10例,游离穿孔3例,三角下穿孔3例.6例有明显冲洗液外渗,10例并发经尿道电切综合征(TURS)或TURS先兆.2例终止手术2周后二期行TURP手术;2例中转行耻骨上经膀胱前列腺摘除术;12例降低冲洗压力继续手术.术后大出血2例,行开放手术止血.所有患者均痊愈出院.结论 TURP过程中出现包膜穿孔,需及时正确判断包膜穿孔的类型和程度,给予相应处理,并注意TURS的预防、治疗.彻底止血、视野清晰及解剖结构清楚能明显降低穿孔的发生率.
목적 탐토량성전렬선증생(BPH)경뇨도전렬선전절(TURP)술중포막천공적원인급방치조시.방법 대2002년2월지2011년2월행TURP술적893례환자적림상자료진행회고성분석.결과 893례환자중,병발포막천공16례,유복개적천공10례,유리천공3례,삼각하천공3례.6례유명현충세액외삼,10례병발경뇨도전절종합정(TURS)혹TURS선조.2례종지수술2주후이기행TURP수술;2례중전행치골상경방광전렬선적제술;12례강저충세압력계속수술.술후대출혈2례,행개방수술지혈.소유환자균전유출원.결론 TURP과정중출현포막천공,수급시정학판단포막천공적류형화정도,급여상응처리,병주의TURS적예방、치료.철저지혈、시야청석급해부결구청초능명현강저천공적발생솔.
Objective To investigate the causes and managements of capsular perforation in transurethral resection of prostate(TURP) for benign prostatic hyperplasia (BPH). Methods Clinical data of 893 cases who received TURP from February 2002 to February 2011 were analyzed retrospectively.Results In 893 cases, capsular perforation in 16 cases, among them, tissue covered perforation in 10 cases, dissociative perforation in 3 cases, perforation under bladder trignne in 3 cases. Six cases occurred with obviously extravasation, 10 cases with transurethral resection syndrome (TURS) or omen of TURS. Two cases were ceased operation and received TURP again after 2 weeks, 2 cases transferred to open surgery suprapubic prostatectomy, 12 cases kept up operation with lower bladder douche pressure. Two cases with postoperatire bleeding underwent open surgery hemostasis cured. All cases were discharged from hospital after recovery. Conclusions The type and extent of capsule perforation must be judged correctly,corresponding treatment must be given, prevention and treatment of TURS must be taken notice of, if capsule perforation occurs when TURP operation in progress. Less haematoma, clearview and normal anatomic structures can decrease the incidence of perforation.