TVP中出现闭孔神经和阴茎勃起反射的原因分析

孙颖浩　王林辉　钱松溪 临床泌尿外科杂志 2000年第6期第15卷

　　摘要　目的：探讨经尿道前列腺电气化术(TVP)中出现闭孔神经和阴茎勃起反射的有关问题。方法：采用TVP治疗前列腺增生症(BPH)156例。结果：术中分别出现闭孔神经反射和阴茎勃起反射8例(5.1%)和7例(4.5%)，均发生于气化电极接近神经分支和气化电流较强时。结论：高频电流中混有低频电流是引起术中神经反射的主要原因，气化电流的大小决定此类反射发生与否。

Nervi obturatorius reflex and penis erection reflex in the process

　　of transurethral electrovaporization of the prostate

SUN Ying-hao　WANG Lin-hui　QIAN Song-xi

　　ZAO Jin-xing　LIAO Guo-xiang　XU Chuan-liang

　　（Department of Urology,the Affiliated Changhai Hospital,Second Military Medical University,Shanghai,200433）

　　Abstract　Purpose:To evaluate the possible mechanism of nervi obturatorius reflex and penis erection reflex appeared in the operation of electrovaporization of the prostate (TVP) and investigate the preventive measures against the reflexes.Methods:The clinical data of 156 cases of benign prostatic hyperplasia (BPH) treated with TVP were summarized.Results:Nervi obturatorius reflex and penis erection reflex appeared in 8 (5.1%) and 7 (4.5%) patients respectively.These reflexes were all appeared when the electrovaporization probe was near the branch of the nervi and the electrovaporization electricity was higher.Conclusions:The main reason of the appearence of the reflexes is lower frequence electricity mixed into high frequence one.The power of the electrovaporization electricity determines the appearence of the reflexes.More attention must be paid to the reflexes in order to avoid perforation of bladder wall or prostate capsule.

　　Key words　Prostatic hypertrophy　Prostatectomy　Obturator nerve　Penile erection　Reflex,abnormal

　　自1996年9月～1998年2月，我院采用经尿道前列腺电气化术(TVP)治疗前列腺增生症(BPH)156例，术中分别出现闭孔神经反射和阴茎勃起反射8例和7例，现报告如下，并分析其发生原因。

　　1　临床资料

　　本组156例，年龄53～89岁，平均69.5岁。大多数患者有较为典型的BPH所致的膀胱颈梗阻症状，其中肉眼血尿26例，尿路感染39例，并发脑梗塞6例，糖尿病21例，高血压47例。所有患者均经直肠指检、腔内B超或CT、膀胱镜检查确诊，其中Ⅰ度增生84例，Ⅱ度增生50例，Ⅲ度增生22例。所有患者均行TVP，气化功率为200～300 W，电凝功率为40～60 W。

　　2　结果

　　2.1　闭孔神经反射

　　8例患者术中出现闭孔神经反射，占5.1%。其中

[1] [2] [3] 下一页