经尿道前列腺电汽化术治疗高龄前列腺良性增生症体会.docVIP

经尿道前列腺电汽化术治疗高龄前列腺良性增生症体会 【摘要】 目的：探讨经尿道前列腺电汽化术治疗高龄良性前列腺增生(BPH)的临床疗效及安全性。方法：采用经尿道前列腺电汽化术治疗56例高龄BPH患者，观察平均手术时间、术中出血量、术后留置导尿管时间、手术并发症及剩余尿量差异。结果：56例患者均安全渡过围手术期，平均手术时间20～50 min，术中出血量30～400ml，术后留置尿管5～7d,剩余尿量由术前160～450ml下降至术后24～50ml，手术前后比较差异均有统计学意义(Plt;0.05)。术后近期疗效满意，无严重并发症。结论：前列腺电汽化术是治疗高龄BPH的一种有效的微创手术，手术操作简便、时间短、出血少、术后恢复快。 【关键词】 前列腺良性增生症 高龄病人 电汽化手术 　　Evaluation of Transurethal Vaporization of Prostate for the Treatment of High-risk Older Patients with Benign Prostatic Hyperplasia Abstract：Objective：To explore the efficacy and safety of transurethal vaporization of prostate (TUVP) in high-risk older patients with benign prostatic hyperplasia (BPH). Method：A total of 56 high-risk older patients with BPH underwent TUVP. The operative time, blood loss indwelling catheterization and operative complications were observed the variables such as uroflowmetry post-void residual urine volume (RUV) were recorded and calculated pre- and post-operatively. Result：All the 56 patients safely got through perioperative period. The mean operative time was 20～50 min intraoperative blood loss was 30～400 ml and postoperative indwelling catheterization was 5～7d . RUV decreased from 160～450 ml to TUVP (24～50) m1. There were significant differences of these parameters between pre-and post-operation (Plt;0.05). There were few complications and great patients satisfaction with the short-term post-operative results. Conclusions：The TUVP is believed to be a safe, efficacious and minimally invasive procedure for older patients with high-risk BPH. It is easier to manipulate with advantages of shorter operative time less blood loss, better tolerance and rapid recovery. 　　Key words： Benign prostatic hyperplasia; High-risk; TUVP 　　良性前列腺增生症(BPH)是泌尿外科常见病和多发病之一，随年龄的增加，其发病率也逐渐上升。年龄大于70岁且合并一种或多种脑、肺等重要脏器疾病，临床上统称为高龄高危BPH。临床上也出现了许多伴有特殊情况的BPH，其中有许多合并有膀胱逼尿肌无力(ACD)的BPH，这些患者手术风险大，采用保守治疗效果差。成为困扰泌尿外科医务人员的临床难点之一。我院应用经尿道前列腺电汽化术（TUVP）治疗56例高龄BPH患者，取得了良好效果。 　　1 资料与方法 　　1．1