高龄高危前列腺增生症患者的微创治疗

Minimally invasive treatment of senile and high risk benign prostatic hyperplasia patients.

目的探讨80岁以上高龄高危前列腺增生症微创治疗的临床疗效和安全性。方法分析自1995年以来,对82例80岁以上高龄合并高危因素的前列腺增生患者行微创治疗的临床资料,其中经尿道前列腺切除术(TURP)治疗55例,高温射频热疗19例,高能聚焦超声治疗8例。结果TURP有效率96·2%,术后排尿不畅5例,暂时性尿失禁3例,继发出血2例,死亡2例。高温射频热疗19例,有效率89·4%,高强聚焦超声治疗8例,有效率87·5%,均无死亡及严重并发症。结论绝大多数80岁高龄合并高危因素前列腺增生症患者,通过微创方法可获得较佳治疗效果,只要按不同的高危因素采取相应的围手术期处理,高龄高危患者通过微创方法治疗仍具有较高的安全性。

Objective To study the efficacy and safety of minimally invasive treatment on the high risk and senile benign prostatic hyperplasia patients. Methods The clinical data of 82 BPH patients over 80 years old accompanied with high risk factor since 1995 were reviewed, including 55 eases with transurethral resection of the prostate （TURP）, 19 eases with radiofrequeney hyperthermia ablation and 8 cases with high intensity focused ultrasound （ HIFU）. Results The efficiency of the TURP was 96.2%, dysuria in 5 eases postoperation, provisionality incontinence in 3eases, succeeding bleeding in 2 cases, and 2 deaths. The efficiency in treatment of the 19 cases with radiofrequency hyperthermia ablation was 89.4%, The efficiency in treatment of the 8 eases with HIFU was 87.5%, and no death or any serious complications were observed. Conclusion High therapeutic effect was achieved in most of the high risk and senile benign prostatic hyperplasia patients through the minimally invasive treatment. With the appropriate management of uarious different high risk factors in the perioperative period, most of the high risk and senile patients could endure a minimally invasive treatment safely.