经尿道切除技术在下尿路疾病中的应用.doc

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1、经尿道切除技术在下尿路疾病中的应用作者：吴越，张国飞，王立，帕尔哈提，沙吾提江，孙大炜　【摘要】目的探讨经尿道切除技术（TUR）治疗下尿路疾病的适应证、操作方法、术中术后处理及并发症预防的要点。方法应用经尿道汽化电切术（TURVP）和双极等离子汽化电切术（TUPKVP），分别以5%葡萄糖液和生理盐水作冲洗介质，选择性耻骨上膀胱造瘘，持续低压灌洗，术后气囊导尿管留置5~7天拔管，自行排尿。结果经尿道前列腺双极等离子汽化电切术7例，经尿道前列腺汽化电切术58例，合计前列腺手术65例；腺性膀胱炎汽化电切术43例；膀胱肿瘤汽

2、化电切术15例；后尿道狭窄等离子汽化电切术3例；精阜腺瘤汽化电切术2例。全部病例均一次手术完成，有效率（126/128）98.4%。无膀胱穿孔、电切综合征、大出血、真性尿失禁发生。前列腺术后尿道狭窄、排尿困难再次手术者2例，占3.08%，排尿疼痛、不适感6例，占9.23%，逆行射精4例，占6.15%。结论TUR技术是一种微创、安全、迅速、有效、恢复快、并发症较少的腔内泌尿外科治疗方法，特别适用于下尿路疾病的手术；术中持续低压灌注对确保切割视野清晰、预防并发症至关重要。　　【关键词】下尿路疾病；TUR技术　　Theap

3、plicationofTURinthetreatmentoflowerurinarytractdisease:areportof128cases　　　【Abstract】ObjectiveToevaluatetheimportantpointsofindication,operationmethod,managementduringoperationandpostoperation,andpreventionofcomplicationsoftransurethralresection(TUR)forthetreat

4、mentoflowerurinarytractdisease.MethodsByapplyingtheoperationmethodoftransurethralelectrovaporization(TURVP),using5%glucoseinjectionandsodiumchlorideinjectionasrinsingmedium,seletivelymakingacystostomyoverpubiccrest,rinsingwithlowpressurecontinouslyandkeepingthe

5、cathetertill5-7daysafteroperation.Results7caseswerereceivedtransurethralbipolarplasmakinetictechniqueelectrovaporizationofprostate,58caseswerereceivedtransurethralelectroveporizationofprostate.Intotal,therewere65casesreceivedprostateoperation.43caseswerereceive

6、delectrovaporizationofcystitisglandularis,15caseswerereceivedelectrovaporizationofbladdertumor,3caseslowerurinaroadnarrownessand2caseshyperplasiaverumontanum.Eachcase’streatmentwascompletedwithonetimeofoperationwithoutoccuringbladderpenetration,electrovaporizat

7、ionsyndromeandbigmassofbleeding.Thecompletelyeffectiverateswas98.4%(126/128).2cases(3.08%)werereceivedsurgeryoperationagainforurinarytractnarrownessanddifficultyofurinating.6cases(9.23%)hadthe4complaintsofurinatingpainfulanduncomfortable.And4cases(6.15%)contrar

8、yspermatism.ConclusionTURisakindoftreatmentmethodofurologywiththecharactiristicsthatit’ssafe,fast,effective,quickrecoverableandhaslesscomplications,andspeciallyinthesurgeryo