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研究生:呂承璋
研究生(外文):Lu, Cheng-Chang
論文名稱:台灣良性攝護腺肥大經尿道攝護腺切除手術術後五年再治療概況及其影響因素探討
論文名稱(外文):Retreat and Risk Factors of Transurethral Resection of the Prostate
指導教授:蔡維河蔡維河引用關係
指導教授(外文):Tsai, Wei-Her
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:醫護管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:66
中文關鍵詞:攝護腺肥大經尿道攝護腺切除手術再治療
外文關鍵詞:BPHTURPretreat.
相關次數:
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背景:隨著平均餘命上升,BPH病患也越來越多,對六十歲到七十歲的男性來說,超過半數患有此病,進而影響生活品質。
目的:了解台灣TURP的手術個案現況、追蹤台灣TURP術後五年再治療(再用藥、再手術)、TURP再治療之危險因子,並將再手術率與國外相關文獻進行比較。
材料:來自衛生署研究計畫所取得的1996-2004全民健康保險資料庫抽樣歸人檔。
方法:以描述性統計及邏輯斯回歸進行資料分析。
結果:台灣在施行TURP手術的品質上,並無比國外差。但其中手術的高輸血率,卻是值得關注的部份。
討論:未來研究者若有興趣在這個議題繼續研究,應將焦點專注於病人的病徵上。
限制:行政資料缺乏完善的疾病病徵指標。
Background: As the life expectancy rises, BPH patient is getting more and more too, to man 60 years old to 70 years old, over half suffers from this disease, and then influence the quality of the life.
Objectives: Understand operation case present situation , Taiwan of TURP , track five years after the operation treat , dangerous factor that TURP treats and then , TURP of Taiwan ,, and the performing the operation rate will correlate with foreign countries documents will be compared again.
Data source: Data set was from the National Health Insurance Research Databases, which covers 1996-2004 span.
Methods: Carry on analysis then for describing statistics and logic regression model.
Results: Taiwan is in implementing the quality of TURP operation, and incomparable and bad abroad. But the high blood transfusion rate of performing the operation among them , is the part of meriting attention .
Conclusions: The researcher in the future is like being interested to continue studying in this topic , should be absorbed in the focus the patient's disease is sought.
第一章 緒論
1
第二章 文獻探討
4
 第一節 良性攝護腺肥大(BPH)
4
 第二節 良性攝護腺肥大(BPH)治療及其預後
7
 第三節 經尿道攝護腺切除手術(TURP)術後復發因素實證研究
14
第三章 研究方法
18
 第一節 資料來源及處理
18
 第二節 研究變項操作型定義
23
 第三節 研究架構
25
 第四節 資料分析
26
第四章 研究結果
27
 第一節 手術個案及復發概況
27
 第二節 研究結果與國內外文獻之比較
37
 第三節 影響攝護腺肥大經尿道切除手術(TURP)復發之羅吉斯迴歸分析
41
第五章 討論與建議
44
 第一節 重要研究結果
44
 第二節 研究限制
46
 第三節 研究建議
46
參考文獻
48
附錄1
55
附錄2
61
中文部份
王惠蓉、劉漢宗(1998)‧良性前列腺肥大之治療‧臺北市藥師公會會刊,16(3),31-38。
吳東霖(2000)‧α1阻斷劑:攝護腺之新武器‧高雄醫師會誌,27,12-14。
李祥生(2006)‧良性攝護腺增生的治療‧臺北市醫師公會會刊,50(11),45-51。
林春梅、譚延輝、吳聖良(2004)‧比較良性攝護腺肥大患者二種治療方式之成本分析‧醫院,37(4),23-35。
林茂盛、吳其翔、謝輝龍、林大鐘、陳兆智、林育慶(2006)‧比較雙極電刀及單極電刀用於良性攝護腺增生的內視鏡刮除手術之效能與安全性:一年追蹤報告‧中臺灣醫學科學雜誌,11(3),143-148。
陳俐君(2000)‧良性前列腺增生‧藥學雜誌,16(2),86-88。
陳憲煜、曾若婷、林士程、陳麗芳(2004)‧Alpha交感神經阻斷劑用於治療良性攝護腺肥大-系統性的回顧‧醫院藥學,21(1),30-53。
劉志光、柯明中、鄭惠升、李文凱、江漢聲(2005)‧以Wedge Loop施行經尿道汽化切除手術治療較大型的攝護腺:兩年之追縱研究‧臺灣泌尿科醫學會雜誌,16(2),74-80。
劉詩彬(2004)‧良性前列腺增生‧台灣醫學,9(4),518-525。
鄭玉亭、李欣南、王強庭(2007)‧良性攝護腺肥大之治療‧臨床醫學,59(2),141-147。
英文部分
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Beduschi, M. C., Beduschi, R., & Oesterling, J. E. (1997). Alpha-blockade therapy for benign prostatic hyperplasia: From a nonselective to a more selective alpha drenergic antagonist. Urology, 51(6), 861-872.
Begg, C. B., Cramer, L. D., Hoskins, W. J., & Brenan, M. F. (1998). Impact of hospital volume on operative mortality for major cancer surgery. Journal of the American Medical Association, 280(2),1747-1751.
Blanchard, K., Hananel, A., Rutchik, S., & Sullivan, J. (2000). Transurethral resection of the prostate: Failure patterns and surgical outcomes in patients with symptoms refractory to alpha-antagonists. Southern Medical Journal, 93(12),1192-1196.
Cooper, K. L., McKiernan, J. M., & Kaplan, S. A. (1999). alpha-adrenoceptor antagonists in the treatment of benign prostatic. Drugs, 57(1), 9-17.
De La Rosette, J. J., Floratos, D. L., Severens, J. L., Kiemeney, L. A., Debruyne, F. M., & Pilar Laguna, M. (2003). Transurethral resection and microwave thermotherapy of the prostate: A cost-consequences analysis. British Journal of Urology, 93(7), 1118-1119.

Fowler, C., McAllister, W., Plail, R., Karim, O., & Yang, Q. (2005). Randomised evaluation of alternative electrosurgical modalities to treat bladder outflow obstruction in men with benign prostatic hyperplasia. Health Technology Assessment, 9(4), 1-30.
Hammadeh, M. Y., Madaan, S., Hines, J., & Philp, T. (2003). 5-year outcome of a prospective randomized trial to compare transurethral electrovaporization of the prostate and standard transurethral resection. Urology,61(6), 1166-1171.
Ho, V., Heslin, M. J., Yun, H., & Howard, L. (2006). Trends in hospital and surgeon volume and operative mortality for cancer surgery. Annals Of Surgical Oncology, 13(6), 851-858.
Holman, C. D., Wisniewski, Z. S., Semmens, J. B., Rouse, I. L., & Bass, A. J. (1999). Mortality and prostate cancer risk in 19,598 men after surgery for benign prostatic hyperplasia. British Journal of Urology, 84(1), 37-42.
Jepsen, J. V., & Bruskewitz, R. C. (1998). Techniques and long-term results of surgical procedures for BPH. European Urology, 49(6), 970-978.
Kang, D., Andriole, G. L., Van De Vooren, R. C., Crawford, D., Chia, D., Urban, D. A., Reding, D., Huang, W. Y., & Hayes, R. B. (2004). Risk behaviours and benign prostatic hyperplasia. British Journal of Urology, 93(9), 1241-1245.

Keoghane, S. R., Lawrence, K. C., Gray, A. M., Doll, H. A., Hancock, A. M., Turner, K., Sullivan, M. E., Dyar, O., & Cranston, D. (2000). A double-blind randomized controlled trial and economic evaluation of transurethral resection and contact laser vaporization for benign prostatic enlargement: A 3-year follow-up. British Journal of Urology, 85(1), 74-78.
Kuntz, R. M. (2006). Laser treatment of benign prostatic hyperplasia. World Journal of Urology, 25(3), 241-247.
Lieberman, M. D., Kilburn, H., Lindsey, M., & Brennan, M. F. (1995). Relation of perioperative deaths to hospital volume among patients undergoing pancreatic resection for malignancy. Annals of Surgery, 222(5), 6387-645.
Lin, H. C., Chang, H. C., Lee, S. C., Yang, C. H., & Tung, Y. C. (2002). Comparisons of LOS for Patients Undergoing a Transurethral Prostatectomy (TURP) by Hospital Level, Hospital Ownership and Hospital Location under the Case Payment System in Taiwan. New Taipei Journal of Medicine, (4)1, 25-33.
Madersbacher, S., Lackner, J., Brössner, C., Röhlich, M., Stancik, I., Willinger, M., & Schatzl, G. (2005). Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: A nation-wide, long-term analysis of 23,123 cases. European Urology, 47(4), 499-504.

Manyak, M. J., Ackerman, S. J., Blute, M. L., Rein, A. L., Buesterien, K., Sullivan, E. M., Tanio, C. P., & Strauss, M. J. (2002). Cost effectiveness of treatment for benign prostatic hyperplasia: An economic model for comparison of medical, minimally invasive, and surgical therapy. Journal of Endourology, 16(1), 51-56.
Masersbacher, S & Marberger, M. (1999). Is transurethral resection of the prostate still justified? British Journal of Urology, 83(3), 227-237.
Melick, H. H., Venrooij, G. E., & Boon, T. A. (2003). Long-term follow-up after transurethral resection of the prostate, contact laser prostatectomy, and electrovaporization. Urology,62(6), 1029-1034.
Melvea, B. P. (1994). Benign prostatic hyperplasia: Diagnosis and treatment. American Family Physician, 49(5), 1157-1165.
Nielsen, S. S., Thulstrup, A. M., Lund, L., Vilstrup, H., & Sørensen, H. T. (2001). Postoperative mortality in patients with liver cirrhosis undergoing transurethral resection of the prostate: A Danish nationwide cohort study. British Journal of Urology, 87(3), 183-186.
Rassweiler, J. (2006). Intrafascial nerve-sparing laproscopic radical prostatectomy: Do we really preserve relevant nerve-fibres? European Urology, 49(6), 955-957.
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