经尿道前列腺电汽化术治疗高危前列腺增生症

The Safety and Efficacy of Transurethral Vaporization of the Prostate in High-Risk Benign Prostatic Hyperplasia

目的:探索经尿道前列腺电汽化术在高龄、危重前列腺增生症患者中的安全性和疗效。方法:对98例高龄高危前列腺增生患者行经尿道前列腺电汽化术手术。总结术前准备注意事项、术中手术技巧以及术后并发症,对比观察手术前、后国际前列腺症状评分、剩余尿量、最大尿流率等指标的差异。结果:手术时间40～90min,平均55 min;切除腺体重12～75 g,平均41.5 g;术中出血量50～400 ml,平均80 ml。术前中心静脉压(7.5±2.5)cmH_2O,术中最高中心静脉压(10.8±3.1)cmH_2O,术后中心静脉压(7.9±2.6)cmH_2O。平均随访12个月,患者国际前列腺症状评分由(27.3±3.1)分降至(7.2±2.9)分,剩余尿量由(310±40)ml降至(25±8)ml,最大尿流率由(8.0±2.8)ml/s升至(25.7±3.1)ml/s。结论:经尿道前列腺电汽化术可作为治疗高龄高危前列腺增生患者安全有效的方法。

Objective：To explore the safety and efficacy of transurethral vaporization of the prostate in old and high risk benign prostatic hyperplasia patients. Methods：We performed transurethral vaporization of the prostate in 98 cases old and high risk benign prostatic hyperplasia. We summarized the preoperative preparation, operation skills,and postoperative complications. We also compared the symptom scores, residual urine volume and and urine flow rate before and after operation. Results： Surgery time is 40-90 min, the mean time is 55 rain. The weight of the gland resected is 12 75 g, the mean weight is 41.5 g. The volume of blood loss is 50 400 ml,mean of 80 ml. The central venous pressure before operation is （7.5 ± 2.5 ）cmH2O. The highest central venous pressure in operation is （10.8±3.1） cmH2O. The central venous pressure after operalion is （7.9±2.6） cmH2O. The average follow-up time is 12 months. The International Prostate Symptom Scores drop from （27.3±3. 1） to （7.2±2. 9）. The residual urine volume drop from （310±40）ml to （25±8） ml. The Qmax ascend from （8.0±2.8） ml/s to （25.7±3.1） ml/s. Conclusions：Transuretbral vaporization of the prostate in old and high risk benign prostatic hyperplasia patients is safe and efficacious.