【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

    The application of TUR in the treatment of lower urinary tract disease:a report of 128 cases

    WU Yue,ZHANG Guo-fei,WANG Li,et al.

    Department of Urology,Xinjiang Jiangong Hospital,Urumqi 830002,China

    【Abstract】 Objective To evaluate the important points of indication,operation method,management during operation and postoperation,and prevention of complications of transurethral resection (TUR) for the treatment of lower urinary tract disease.Methods By applying the operation method of transurethral electrovaporization (TURVP),using 5% glucose injection and sodium chloride injection as rinsing medium,seletively making a cystostomy over pubic crest,rinsing with low pressure continously and keeping the catheter till 5-7 days after operation.Results 7 cases were received transurethral bipolar plasmakinetic technique electrovaporization of prostate,58 cases were received transurethral electroveporization of prostate.In total,there were 65 cases received prostate operation.43 cases were received electrovaporization of cystitis glandularis,15 cases were received electrovaporization of bladder tumor,3 cases lower urina road narrowness and 2 cases hyperplasia verumontanum.Each case’s treatment was completed with one time of operation without occuring bladder penetration,electrovaporization syndrome and big mass of bleeding.The completely effective rates was 98.4% (126/128).2 cases (3.08%) were received surgery operation again for urinary tract narrowness and difficulty of urinating.6 cases (9.23%) had the complaints of urinating painful and uncomfortable.And 4 cases (6.15%) contrary spermatism.Conclusion TUR is a kind of treatment method of urology with the charactiristics that it’s safe,fast,effective,quick recoverable and has less complications,and specially in the surgery of lower urinary tract disease.Continously rinsing with low pressure is very important during the operation for keeping the field clearly and preventing complications. ......