经尿道等离子体双极汽化电切术治疗高龄高危前列腺增生症患者的临床探讨（附248例报告）

Clinical research of transurethal plasmakinetic resection of prostate in treatment of advanced age and high risk patients with prostatic hyperplasia（ REPORT OF 248 CASES）

目的探讨经尿道等离子体双极汽化电切术（PKRP）治疗高龄高危前列腺增生症（BPH）患者的安全性及策略。方法自2003年9月至2011年12月共248例高龄高危良性前列腺增生症患者行经尿道等离子体双极汽化电切术（PKRP），术前进行风险评估及充分准备，改进手术操作技巧，提高围手术期安全。结果手术时间30～100min，平均70min；切除前列腺组织重45～110g，平均55g。术中出血少，无输血。248例患者均安全渡过围手术期，无电切综合征（TURS）和真性尿失禁等严重并发症。早期暂时性尿失禁18例，经口服“酒石酸托特罗定片”和提肛训练1—3周恢复。所有患者随访6个月以上，排尿症状消失或明显改善。结论经尿道等离子体双极汽化电切术（PKRP）仍是治疗高龄高危前列腺增生症患者安全、有效的方法。

Objectives To investigate the safety and tactics of transurethal plasmakinetic resection of pros- tate （PKRP）in treatment of advanced age and high risk patients with prostatic hyperplasia. Methods From Sep- tember 2003 to December 2011 ,PKRP was performed on 248 advanced age and high risk patients of prostatic hyper- plasia. Adequate preoperative preparation and risk evaluation and improvement of the operation skills are important for enhancement of preoperative safety. Results Operation time were from 30 - 100min（ average 70min） and 45 - 110g（ average 55g） of prostate tissue were resected with less bleeding. All the 248 cases rode out perioperative pe- riod safely without complications of transurethral resection syndrome（Tuns） and real urinary incontinence. 18 cases of early transient urinary incontinence recovered through oral administration of Tartaric acid tot of Landing and 1 - 3 weeks of anal sphincter contracting exercises, all patients recover or partially recover from urination disorder during 6 ＋ months follow - up. Conclusions PKRP is a safe and effective means for treatment of prostatic hyperplasia for advanced age and high risk patients.