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1、等离子体切割系统经尿道前列腺剜除术作者:夏国伟孙传玉徐可丁强张元芳作者单位:200040上海;复旦大学附属华山医院泌尿外科【摘要】目的提高前列腺增生症治疗水平,推广微创手术在泌尿外科中的应用。方法应用GyrusPKS等离子体双极切割系统和电切镜,使用生理盐水作为工作介质和冲洗液,经尿道切除前列腺200余例,采用推切技术将增生的前列腺剜除后切除,手术为时间60~120min。结果手术顺利,术中、术后无输血及低钠综合症,术后膀胱冲洗0.5~1d,4~5d拔导尿管,排尿通畅,一周出院。结论与TURP(尿道前列腺电切术)相比:①等离子体双极
2、切割系统使用生理盐水作为工作介质和冲洗液,避免了低钠综合症;②使用双极回路,电刺激小,发生闭空神经反射机会少,有汽化和切割作用;③工作温度低对周围组织影响小,能减少尿道刺激症状,对勃起神经损伤危险小;④汽化和切割时有封闭血管的作用,出血少,水吸收少。【关键词】前列腺增生症;等离子体双极切割系统;前列腺剜除术TransurethralEnucleationofProstateforBenignProstaticHyperplasiaUtilizingtheGyrusplasmaKineticSystemXiaGuowei,SunChu
3、anyu,XuKe,DingQiang,ZhangYuanfangDepartmentofUrology,HuashanHospital,FudanUniversity,Shanghai200040【Abstract】ObjectiveToimprovediagnosisandtreatmentofBPHandtoexpandtheapplicationofminimalinvasivesurgeryinurology.Methods200BPHcaseswereperformedtransurethralenucleationofp
4、rostateutilizingtheGyrus-plasmakineticsystem.Normalsalinewasusedasworkingmediumandirrigationliquid.Pushingresectiontechniquewasappliedtoenucleateprostaticadenoma.Theoperationtimewas1~2hours.ResultsAlltheoperationsweresuccessful.Therewasnotransfusionandhyponatremiaintheg
5、roup.Theirrigationtimewas0.5~1day.Urethralcatheterwasremoved4~5daysaftersurgery.Allpatientsdischargedsuccessfully,passingtheirwatercomfortably.Thelengthofstaywasoneweek.ConclusionComparedwithTURP,suchtechniquehasseveraladvantages.First,normalsalinewasusedasworkingmedium
6、andirrigationliquidtoavoidhyponatremia.Second,bipolarelectroresectionorvaporizationcanminimizetheriskoftheobturatorreflex.Third,lowworkingtemperaturecanminimizetheinjurytourethraandpelvicnerve.Fourth,electroresectionorvaporizationhastheeffectofenoughhaemostasisandlessli
7、quidabsorption.Fifth,pushingresectiontechniqueishelpfultomaximizethevolumeofresectedissue.【Keywords】benignprostatichyperplasis;gyrusplasmakineticsystem;transurethralenucleationofprostate2003年3月~2008年5月,我们应用经尿道前列腺双极等离子电切术(plasmakineticresectionoftheprostate,PKRP)治疗良性前列腺
8、增生症(benignprostatichyperplasis,BPH)200例,效果满意,现报告如下。1资料与方法1.1临床资料本组200例,年龄58~87岁,平均69岁。经直肠B超测前列腺体积35~116ml,平均61