经尿道电切术治疗高龄高危前列腺增生症

Transurethral Resection of Prostate for BPH in Senior High Risk Patients

目的:探讨经尿道前列腺电切术治疗高龄高危前列腺增生症的安全性和疗效。方法:对132例80岁以上高危良性前列腺增生症患者行经尿道前列腺电切术。患者手术时间30～60min,平均(40±3)min。术中未发生经尿道电切综合征、大出血。结果:随访3～72个月,平均(16±2)个月。国际前列腺症状评分平均值由术前(21.5±6.9)分降到(9.3±4.2)分,最大尿流率(MFR)由(6.8±1.3)ml/s增加至(17.8±2.5)ml/s。生活质量评分(QOL)由(5.5±1.4)分降至(3.1±0.5)分,残余尿量(PVR)由(160±5)ml降至(25±1.5)ml,差异均有统计学意义(P<0.05)。全部病例术后均排尿通畅,术后均未有心、脑、肝、肾等系统疾病加重。结论:只要术前积极控制并发症,医师技术娴熟,经尿道前列腺电气化切除术是当今治疗80岁以上高危前列腺增生症的安全、有效的方法。

Objective ：To evaluate the safety and effectiveness of transurethral resection of prostate（TURP） in senior high risk patients with benign prostatic hyperplasia（BPH）.Methods ：A total of 138 patients, all aged over 80 years, with benign prostatic hyperplasia underwent TURP in our institution.The average operation time was （40±3）rain, range ： 30-60 rain.No transurethral resection syndrome or massive bleeding occurred during the operation.Results ：All patients were followed up for 3 to 72 months, mean ： （16±2）months.The International Prostate Symptom Score（SPSS） decreased from 21.5±6.9 to 9.3±4.2, Quality of Life（QOL） from 5.5±1.4 to 3.1±0.5 and postvoid residual volume（PVR） from （160±5）ml to （25±1.5）ml, whereas maximum urinary flow-rate increased from （6.8±1.3）ml/s to （17.8±2.5）ml/s.All differences were statistically significant（P〈0.05）.Postoperatively, all patients had fluent urination.No further damage to heart, brain, liver, kidney or other systems were observed in any patient.Conclusion ：Performed by an experienced urologist with proper perioperative management, TURP is a safe and effective treatment modality in senior high risk patients.