中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
26期
28-30
,共3页
王民%史斌%王绍平%王大庆%王庆宏%臧青山%孙扬
王民%史斌%王紹平%王大慶%王慶宏%臧青山%孫颺
왕민%사빈%왕소평%왕대경%왕경굉%장청산%손양
前列腺增生%经尿道前列腺切除术%Nesbit法%分割、撬剥切割法
前列腺增生%經尿道前列腺切除術%Nesbit法%分割、撬剝切割法
전렬선증생%경뇨도전렬선절제술%Nesbit법%분할、효박절할법
Prostatic hyperplasia%Transurethral resection of prostate%Nesbit technique%Prying-up technique
目的 探讨大体积前列腺经尿道双极等离子体切除方法的有效性及安全性.方法 回顾性分析经尿道双极等离子体切除大体积前列腺105例患者的临床资料.采用顺行切割(Nesbit法组,45例)和经尿道分割、逆行撬剥切割(分割、撬剥切割法组,60例)两种不同切割方法,比较两组手术时间、术中及术后出血量、术后持续膀胱冲洗时间等指标.结果 Nesbit法组平均切除腺体组织效率(0.79±0.17)g/min、平均切除腺体组织出血量(3.87±1.09)ml/g、术后24 h Hh下降(6.84±3.96)g/L、术后平均持续膀胱冲洗时间72h、输血8例;分割、撬剥切割法组分别为(1.16±0.20)g/min、(1.60±0.64)ml/g、(3.87±2.33)g/L、36h、无一例输血.两组比较差异均有统计学意义(P＜0.05).结论 对于大体积前列腺采用分割、逆行撬剥切割法经尿道双极等离子体切除,与Nesbit法比较具有出血量少、手术时间短、冲洗液用量少、切除腺体彻底、安全性高,并可规范手术操作、便于教学推广等优点.
目的 探討大體積前列腺經尿道雙極等離子體切除方法的有效性及安全性.方法 迴顧性分析經尿道雙極等離子體切除大體積前列腺105例患者的臨床資料.採用順行切割(Nesbit法組,45例)和經尿道分割、逆行撬剝切割(分割、撬剝切割法組,60例)兩種不同切割方法,比較兩組手術時間、術中及術後齣血量、術後持續膀胱遲洗時間等指標.結果 Nesbit法組平均切除腺體組織效率(0.79±0.17)g/min、平均切除腺體組織齣血量(3.87±1.09)ml/g、術後24 h Hh下降(6.84±3.96)g/L、術後平均持續膀胱遲洗時間72h、輸血8例;分割、撬剝切割法組分彆為(1.16±0.20)g/min、(1.60±0.64)ml/g、(3.87±2.33)g/L、36h、無一例輸血.兩組比較差異均有統計學意義(P＜0.05).結論 對于大體積前列腺採用分割、逆行撬剝切割法經尿道雙極等離子體切除,與Nesbit法比較具有齣血量少、手術時間短、遲洗液用量少、切除腺體徹底、安全性高,併可規範手術操作、便于教學推廣等優點.
목적 탐토대체적전렬선경뇨도쌍겁등리자체절제방법적유효성급안전성.방법 회고성분석경뇨도쌍겁등리자체절제대체적전렬선105례환자적림상자료.채용순행절할(Nesbit법조,45례)화경뇨도분할、역행효박절할(분할、효박절할법조,60례)량충불동절할방법,비교량조수술시간、술중급술후출혈량、술후지속방광충세시간등지표.결과 Nesbit법조평균절제선체조직효솔(0.79±0.17)g/min、평균절제선체조직출혈량(3.87±1.09)ml/g、술후24 h Hh하강(6.84±3.96)g/L、술후평균지속방광충세시간72h、수혈8례;분할、효박절할법조분별위(1.16±0.20)g/min、(1.60±0.64)ml/g、(3.87±2.33)g/L、36h、무일례수혈.량조비교차이균유통계학의의(P＜0.05).결론 대우대체적전렬선채용분할、역행효박절할법경뇨도쌍겁등리자체절제,여Nesbit법비교구유출혈량소、수술시간단、충세액용량소、절제선체철저、안전성고,병가규범수술조작、편우교학추엄등우점.
Objective To study the effectiveness and safety of methods of transurethral bipolar plasmakinetie prostatectomy for benign prostatic hyperplasia with large volume.Methods The transurethral bipolar plasmakinetic prostatectomy with Nesbit (Nesbit group,45 cases)and prying-up technique (pryhag-up group,60 cases)were performed in 105 patients of the prostatic volume of more than 60 g.The results could be obtained by comparing operative time,intraoperative and postoperative blood loss and the time of postoperative sustained washing of the bladder between the two groups.Results In Nesbit group,the efficiency of average cutting gland was (0.79±0.17)g/min,the average intraoperative blood loss was (3.87± 1.09)ml/g,the decrease in postoperative Hb within 24 hours was (6.84±3.96)g/L,the average time of postoperative continuous washing of the bladder was 72 hours,8 patients were given by blood transfusion.In prying-up group,the corresponding data were(1.16±0.20) g/min,(1.60±0.64)ml/g,(3.87±2.33 )g/L,36 hours respectively,none of patients was given by blood transfusion.There were statistically significant in two groups(P＜0.05).Conclusions The adoption of prying-up is more favorable compared with Nesbit method in the aspects such as less blood loss,shorter operating time,less lotion,more thorough resection of the gland,higher security.It is conducive to delivering lecture,and it enables the standard operational procedure available.
