双睾切除术并用中药温阳利水治疗前列腺肥大症38例临床分析

本文对38例无手术摘除前列腺指征患者采用双睾切除术,其中13/38(34.2%)术后因膀胱逼尿肌无力仍不能排尿者加用中药温阳利水法,使其中11例恢复排尿。近期疗效:术后恢复排尿33例占86.8%,5例无效占13.2%;32/38例经1～4年随访,优组22例68.8%,良组5例15.6%,无效5例15.6%,总有效率为84.4%;讨论了温阳利水法治疗机理及球鞋带固定导尿管方法及管理要点。

英文摘要:

This paper reports 38 cases of prostatic hypertrophy(admitted from Feb.1979 to Mar.1983),who had no indications for prostatectomy and were treated by bilateral orchiectomy.13 of the 38 patients (34.2%)who could not evacuate urine after operation owing to atony of bladder detrusor were further treated with TCM therapy of promoting Yang for diuresis.11 of the 13 cases recovered in satisfactory. The total effective rate was thus raised markedly.33 cases(86.8%)recovered urinary evacuation after operation.5 cases(13.2%)showed no effect.32 cases were followed up for 1-4 years.According to Yang wenzhi’s criteria group with satisfactory result 22 cases(68.8%);group with improvement 5 cases(15.6%); group with no effect 5 cases(15.6%)and total efficacy rate 84.4%.Of the 19 cases out of 32,A-type ultrasonography showed no residual urine in 17 cases.2 cases of the group with improvement had residual urine(70-100ml).In 11 of the 32 cases,prostatic examination showed that the prostate diminished in 7 cases(average transverse diameter decreased 0.5-1.0 cm);4 patients had no change(three of the four patients were followed up less than one year).The mechanism of the method promoting Yang for diuresis was discussed,the method of fixing urinary catheter with shoestring and proper nursing care were recommanded.In conclusion,bilateral orchiectomy combined with TCM therapy is an acceptable simple and safe method,with no severe complication and specially suitable for old patients who cannot stand prostatectomy.

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