经尿道双极等离子体电切术治疗高危前列腺增生症256例

Transurethral resection of prostate with liasmakinetic energy in the treatment of high risk patients with benign prostatic hyperplasia

目的:探讨经尿道双极等离子体电切术(PKRP)治疗高危良性前列腺增生症(BPH)的安全性及疗效。方法:采用PKRP治疗高危BPH患者256例,前列腺大小45～109.4g,平均60±5g,随访3～18个月。结果:手术安全顺利,时间20～60min,出血少,无水中毒与尿失禁发生,无死亡病例。按国际前列腺症状评分(IPSS)由术前25.5±4.1分下降至术后9.0±2.1分;生活质量评分由术前5.0±1.0分,下降至术后2.1±0.5分;最大尿流率由术前6.5±2.8ml/s上升至术后14.3±5.2ml/s;残余尿由术前121±12.5ml降至术后18.1±13.6ml。手术前后比较,差异均有统计学意义(P<0.01)。结论:充分术前准备的情况下PKRP是高危BPH新的治疗方法,该术式具有安全性高,手术指征相对较宽、易掌握、并发症少、疗效确切等优点。

Objective：To evaluate the clinical efficacy and safety of PKRP in the treatment of high risk patients with benign prostatic hyperplasia.Methods：256 cases of high risk BPH.Patients were treated with PKRP,The mean age of patients was 74.6（70～89）years;and the prostate weight was 60±5（45～109.4）g.All the cases were followed up for 3～8months.Results：All operations were successful.The average operative time were（20～60） min.There were less intraoperative bleeding,no postoperative temporary urinary in continence,no Turs,and no death.Tn the preoperation,IPSS,QOL,Qmax,PVR were（25.5±4.1）scores,（5.0±1.0）scores,（6.5±2.8）ml/s,（121±12.5）ml.While in the postoperation,these paraments were（9.0±2.1）scores,（2.1±0.5）scores,14.3±5.2）ml/s,（18.1±13.6）ml.Respectively,significant difference were found between the preoperation and post operation（P〈0.01）.Conclusion：PKRP is a new treatment option for high risk patients with BPH.Our experience indicated that PKRP is a less complicated safe and effective approach.