经尿道前列腺气化电切术治疗高龄高危前列腺增生患者临床分析.docVIP

经尿道前列腺气化电切术治疗高龄高危前列腺增生患者临床分析 　　【摘要】 目的 评估经尿道前列腺电气化切除术治疗高龄、高危患者的安全性、疗效及注意事项。方法 应用铲状电极经尿道气化术联合电切术治疗144例75岁以上高危良性前列腺增生症(benign prostatic hyperp lasia,BPH)患者,其中前列腺20～40 g 61例，40～80 g 50例，80 g以上23例。结果 144例患者手术时间32～98 min,平均61 min，术中失血10～200 ml，平均90 ml 。电切前列腺组织22～140 g，平均66 g;发生电切综合征(TURS)2例，大出血2例后在膀胱镜下止血，前列腺偶发癌1例，无手术死亡。国际前列腺症状评分(international p rostatic symp tom score,IPSS)平均值由术前27．8降至8．3分，平均最大尿流率Qmax由6．1 ml/s增至14．2 ml/s。随访3～12个月,平均10．8个月。全部患者术后均排尿通畅。一过性尿失禁9例，3个月后好转。所有患者术后均未有心、脑、肝、肾等系统疾病加重，生活质量显著提高。结论 应用铲状电极气化切割,联合电切环修切,切割增生组织速度较快,安全有效,并发症少,疗效显著。是治疗75岁以上高龄高危BPH患者的安全、有效的方法。 　　【关键词】前列腺增生症;经尿道前列腺电气化切除术;高龄高危 　　 　　Transurethra vaporization prostatomy in the treatment of benign prostate hypertrophy 　　 　　QIAN Jin-ke,LIU Hui,ZHU Wei-dong.Department of Urology,the People‘s Hospital of Binhai 214500,China 　　 　　【Abstract】 Objective To observe the clinical effect of transurethra vaporization prostatomy(TUVP)of benignprostate hypertrophy (BPH)in the older patients,and to raise the efficacy and safety of operation.Methods Shovel-shaped electrode transurethral vaporization combined with electric prostatectomy therapy was performed in 144 cases.Among them,the weight of benignprostate hypertrophy was 20-40 g in 61cases,40-80 g in 50 cases,over 80 g in 23 cases.Results Average operation time was 61 minutes and average blood loss volume was 90 ml.Average weight of dissected prostatic tissue was 66 g.2 cases suffered from transurethra prostatomy syndrom and 2 cases suffered from blooding and was stopped and no death occurred.IPSS scoring decreased from 27．8 to 8．3 after operation during 3-12 months in 144 cases,and life quality obviously improved.Conclusion Electrode vaporization dissection combined with electric ring-shaped dissection can speed up the time of dissecting hyperplastic tissue,which is safe and effective,with few complications. 　　【Key words】Benign prostate hyperplasia;Transurethra vaporization prostatomy;Enile and high risk patients 　　 　　前列腺增生症是困扰老年男性疾病的一种常见病。随年龄的增