经尿道前列腺汽化术治疗合并心脑血管疾病的良性前列腺增生

Transurethral vaporization of prostate for BPH patients with cardiovascular and cerebrovascular diseases

目的探讨经尿道前列腺汽化术(TUVP)治疗合并心脑血管疾病的良性前列腺增生(BPH)患者的安全性及有效性。方法应用TUVP治疗合并心脑血管疾病的BPH患者63例。灌注液常为5%甘露醇,肾功能不全患者使用5%葡萄糖。如腺体小于或等于75g,则彻底切除;如腺体大于75g,年龄大于80岁,则作前列腺部分切除术。行国际前列腺症状评分(I-PSS),观察手术效果,评价手术安全性。结果该组63例患者均安全耐受手术。手术时间28～104min,平均52min。3～5d后拔除导尿管后排尿通畅。术后3个月I-PSS平均11.8分,最大尿流率(Qmax)平均16.5mL/s,与术前(I-PSS平均30.3分,Qmax平均6.5mL/s)相比差异均具有显著性(P<0.01)。2例行膀胱颈修切时出现包膜穿孔,发生电切综合征(TURS)先兆3例均及时处理,1例脑梗死患者,因长期服用抗凝药,术后出血行二次TUVP。结论TUVP是治疗合并心脑血管疾病的BPH患者安全有效的手术方式。

[Objective] To evaluate the safety and efficacy of transurethral vaporization of the prostate (TUVP) for benign prostatic hyperplasia(BPH) patients with cardiovascular and cerebrovascular diseases. [Methods] TUVP was undertaken for 63 BPH patients with cardiovascular and cerebrovascular diseases. The irrigation was usually 5% mannitol, but 5% glucose in patients with renal dysfunction. If the weight of prostate was less than 75 g, the prostate were resected completely. If the weight of prostate was higher t...