CAJ | 학술논문

目的观察对比耻骨上经膀胱前列腺摘除术与经尿道前列腺电切术(TURP)的优缺点及术后患者的主要并发症.方法2000年3月-2012年8月,我院采用耻骨上经膀胱前列腺摘除术(简称耻骨上组)和经尿道前列腺电切术(简称TURP组)治疗前列腺增生症928例,比较两组患者手术时间、失血量、手术并发症发生率.结果两组手术均顺利,无手术死亡病例.手术后3d1例并发肺梗死,2例并发脑梗死,均治愈.耻骨上组操作简单,技术易掌握,无论腺体大小均不需输血,手术时间也较恒定,术后因腺体残留导致复发及尿道狭窄的发生率均低于TURP组;而TURP组则具有无手术切口、住院时间短、损伤轻,恢复快,术后膀胱痉挛发生率显著降低且程度轻、时间短、疼痛明显减少等优点.术后切口并发症、膀胱痉挛、尿路感染发生率高,住院时间长,抗生素使用时间长是耻骨上组缺点,而术中可能发生电切综合症,术后腺体残留增生再手术及术后继发出血发生率高,尿道狭窄及暂时性尿失禁等并发症发生率高是TURP的缺点.结论耻骨上组及TURP组均为治疗前列腺增生症的有效方法,两种方法各有优缺点.TURP组优于耻骨上组,仍为治疗前列腺增生症的金标准.
목적관찰대비치골상경방광전렬선적제술여경뇨도전렬선전절술(TURP)적우결점급술후환자적주요병발증.방법2000년3월-2012년8월,아원채용치골상경방광전렬선적제술(간칭치골상조)화경뇨도전렬선전절술(간칭TURP조)치료전렬선증생증928례,비교량조환자수술시간、실혈량、수술병발증발생솔.결과량조수술균순리,무수술사망병례.수술후3d1례병발폐경사,2례병발뇌경사,균치유.치골상조조작간단,기술역장악,무론선체대소균불수수혈,수술시간야교항정,술후인선체잔류도치복발급뇨도협착적발생솔균저우TURP조;이TURP조칙구유무수술절구、주원시간단、손상경,회복쾌,술후방광경련발생솔현저강저차정도경、시간단、동통명현감소등우점.술후절구병발증、방광경련、뇨로감염발생솔고,주원시간장,항생소사용시간장시치골상조결점,이술중가능발생전절종합증,술후선체잔류증생재수술급술후계발출혈발생솔고,뇨도협착급잠시성뇨실금등병발증발생솔고시TURP적결점.결론치골상조급TURP조균위치료전렬선증생증적유효방법,량충방법각유우결점.TURP조우우치골상조,잉위치료전렬선증생증적금표준.
Objective To compare the relative merits and the mainpostoperative complications of suprapubic suprapublic transvesical prostatectomy(SPPC) and transurethral resection of the prostate(TURP). Methods 928 cases of benign prostatic hyperplasia(BPH) were treated with either SPPC or TURP, comparing the two groups patient`s time of operation, blood loss volume, the incidence of surgical complications. Results The operation of two groups are both successfully, no operative deaths.One case occur pulmonary infarction, while two cases occur cerebral infarction, all of them werecured. SPPC have the characteristics of simplicity of operator,easy to master, and does not have blood transfusion no matter the size of glands, the time of operation also under controll, while the recurrence rate of gland residual hyperplasia and urethral stricture are lower than TURP; but the TURP have the characteristics of no incision, short operative time, light damage, rapid recovery, the recurrence rate of bladder spasm significantly reduced, pain reducegreatly. SPPC have some shortcomings, including higher recurrence rate ofpostoperative incision complications, bladder spasm,urinary tract infection, the longer time of hospitalization and antibiotic use; while the TURP also haveshortcomings includes postoperative electric cutting syndrome, reoperation ofprostate hyperplasia of residual, higher rate of secondary bleeding, urethral stricture, temporary incontinence, and so on. Conclusion Both SPPC and TURP are effetive way to remedy benign prostatic hyperplasia, but also have theirrelative merits. TURP is better than SPPC, still the gold standard to remedybenign prostatic hyperplasia.