前列腺良性增生症合并混合痔同期手术治疗临床观察.docVIP

前列腺良性增生症合并混合痔同期手术治疗临床观察［摘要］ 目的:评价前列腺增生症合并混合痔（即痔-前列腺增生综合征）同期行手术治疗的效果与安全性。方法:对9例痔-前列腺增生综合征患者行经尿道双极等离子前列腺切除术（PKRP）治疗前列腺良性增生（BPH），同时行痔上黏膜环形切除术（PPH）治疗混合痔。结果：患者均顺利出院，无切口感染和手术死亡病例。随访6～36个月，痔未复发，排尿、排便通畅，术后最大尿流率＞15 mls-1，国际前列腺症状评分0～8分。结论：对痔-前列腺增生综合征患者同期行PKRP和PPH疗效好，并发症少，恢复快，可一次完成手术，避免二次手术的痛苦。 ［关键词］ 良性前列腺增生症； 混合痔； 经尿道双极等离子前列腺切除术； 痔上黏膜环形切除术 ［中图分类号］ R697.32; R657.18 ［文献标识码］ A ［文章编号］ 1671-7562（2011）01-0064-03 doi:10.3969/j.issn.1671-7562.2011.01.省略 Observation on surgical treatment for prostatic hyperplasia mixed with hemorrhoid LI Tie-gang （Judicial Police Hospital of Hunan Province, Changsha 410014, China） ［Abstract］ Objective: To evaluate the effect and safety of prostatic hyperplasia combined with mixed hemorrhoids underwent surgery during the same period. Methods: Benign prostatic hyperplasia（BPH） was treated by bipolar plasmakinetic resection of prostate（PKRP）, co-existing hemorrhoids was simultaneously given procedure for prolapsed and hemorrhoids（PPH）. Results: The patients were discharged without surgical wound infections and deaths. Followed up for 6 to 36 months, no recurrence of hemorrhoids, urination, defecation smooth, the postoperative peak flow rate was more than 15 mls-1, and the international prostate symptom were scored 0 to 8 points. Conclusion: Simultaneous PKRP and PPH surgery given to the patients with prostatic hyperplasia combined with mixed hemorrhoids leads to more effectiveness, less complications, quicker recovery, which avoids the pain of a secondary surgery. ［Key words］ benign prostatic hyperplasia； mixed hemorrhoids； bipolar plasmakinetic resection of prostate； procedure for prolapsedand hemorrhoids 前列腺与肛门直肠起源于泄殖腔，成人的终末直肠前方与前列腺相邻，二者由同一血管、神经分布，故前列腺增生症与痔常同时伴发，且互为影响，临床上称之为痔-前列腺增生综合征，以往采取分期手术或者分科治疗。我院2008年1月至2010年1月对9例痔-前列腺增生综合征患者，同时行经尿道双极等离子前列腺切除术（bipolar plasmakinetic resection of prostate，PKRP）和痔上黏膜环形切除术（procedure for prolapsed and hemorrhoids，PPH），取得较好的疗效，现报道如下。 1 资料与方法 1.1 一般资料 9例痔-前列腺增生综合征患者，年龄61～85岁，平均72.0