等离子体切割术治疗高龄及高危前列腺增生症

Plasmakenitic vaporization of prostate in the treatment of senior and high risk benign prostatic hyperplasia

目的探讨等离子体切割术治疗高龄、高危前列腺增生患者的疗效及安全性。方法对58例高龄、高危前列腺增生患者采用等离子体前列腺切割术治疗。结果55例1次手术成功,2例因术后出血行二次电凝止血,1例分2次手术。平均手术操作时间42min,平均失血量40mL,平均切割前列腺组织16g,未输血,无经尿道电切综合征发生。国际前列腺症状评分(IPSS)及生活质量评分(QOL)由术前29.5±5.2和5.0±0.6下降至8.1±2.3和1.2±0.3,最大尿流率(Qmax)由术前(5.6±2.8)mL/s增加至术后(16.7±3.2)mL/s,手术前后比较差异均有统计学意义(P<0.05)。无1例发生原有心、脑、肺、肾等合并症加重。结论等离子体前列腺切割术出血少,安全性高,尤其适合于高龄、高危前列腺增生患者。

Objoctive To investigate the therapeutic effect and safety of plasmakenitic vaporization of prostate （PKVP） in the treatment of senior and high risk benign prostatic hyperplasia （BPH）. Mothods PKVP was used to treat 58 cases of senior and high risk BPH. Results 55 cases succeeded with one operation and 3 cases needed a second surgery. The mean operative time was 42 min, blood loss was 40 mL and the resected prostate tissue weighted 16 g. No patients needed blood transfusion and no transurethral resection syndrome （TURS） occurred. International prostate symptom score （IPSS） and quality of life （QOL） scores decreased from 29.5 ± 5.2 and 5.0 ± 0.6 before operation to 8.1 ± 2.3 and 1.2 ± 0.3 after operation. Qmax increased from （5.6 ± 2.8） mL/s to （16.7 ± 3.2） mL/s. There were significant differences of these parameters before and after operation （P〈0.05）. No patients had aggravated complications. Conclusion PKVP can be particularly applied to senior and high risk BPH with less bleeding and more safety.