高龄及高危前列腺增生的腔内治疗(附228例报告)

Endourological treatment of senile high risk patients with benign prostate hyperplasia(Report of 228 cases)

目的：探讨高龄及高危BPH患者腔内治疗的安全性和有效性。方法：分析228例高龄及高危BPH患者应用经尿道等离子体双极汽化电切术的临床资料。结果：手术时间15～240min，无TURP综合征发生．平均出血量80ml，围手术期无患者死亡。随访4～30个月，排尿功能恢复良好，IPSS评分由术前平均30，2分下降到术后平均9，1分，QOL评分由术前5，8分下降到平均2，2分，最大尿流率（Qmax）由术前6，7ml／min上升到平均18，6ml／min。结论：对高龄及高危BPH患者应用经尿道等离子体双极汽化电切术安全有效，采用个性化治疗方案，加强术前监控与调整，做好术中、术后每一细节处理是保证手术效果及围手术期安全的关键。

Objective： To evaluate the safety and efficacy of transurethral plasmakinetic vaporization （TUPKVP） for senile high risk patients with benign prostate hyperplasia. Methods：The clinical experiences of transurethral plasmakinetic vaporization （TUPKVP） treatment in 228 cases of benign prostate hyperplasia were analyzed Results：Total 228 patients underwent TUPKVP safely. The operating time was from 15 to 240 minutes, the mean blood loss was 80 ml. With follow up of 4-30 months, all patients had fluent urination, the International Prostate Symptom Scores （IPSS） were decreased from 30.2 to 9.1, Quality of Life （QOL） decreased from 5.08 to 2. 2. Maximal flow rate（Qmax）increased from 6.7 ml/min to 18.6 ml/min. Conclusion： TUPKVP is a safe and effective therapy to senile high risk patients with benign prostate hyperplasia. The Individual treatment,intensive monitoring and adjustment before operation, and skilled manipulation are the keys to the success.