经尿道前列腺等离子切割治疗高龄高危前列腺增生症

Transurethral Plasma Kenitic Vaporization of Prostate for the Treatment of Senior and High Risk Benign Prostatic Hyperplasia

【目的】探讨经尿道前列腺等离子体切割术（PKVP）对高龄高危前列腺增生症的疗效及安全性。【方法】对66例行PKVP术的高龄高危前列腺增生患者的临床资料进行回顾性总结。【结果】66倒手术1次性成功，手术时间55～112min，平均（76．8±15．5）min；术中失血90～150mL，平均（115．7±15．2）mL；术后3个月国际前列腺症状评分（IPSS）（6．6±4．3）分和生活质量评分（QOL）（2．8±0．8）分较治疗前的（27．8±4．6）分和（5．6±0．6）分显著下降（P〈0．01）；最大尿流率（Qmax）（13．4±3．4）mL／s较治疗前的（6．8±2．4）mL／s显著增加（P〈0．01），残余尿量（PVR）（18．5±3．6）mL较术前（68．5±12．4）mL显著减少（P〈0．01）；无电切综合征病例及死亡病例。【结论】PKVP出血少、时间短、安全性高，高龄高危前列腺增生患者并非麻醉、手术的绝对禁忌。

[Objective] To explore the efficacy and safety of transurethral plasma kenitic vaporization of prostate（PKVP） for the treatment of senior and high risk benign prostatic hyperplasia（BPH）. [Methods] The clinical data of 66 cases of senior and high risk BPH treated by PKVP were analyzed retrospectively. [Results] All the 66 cases were treated successfully with one-time operation. The operation time was 55-112min（average 76.8±15.5rain）. Intraoperative blood loss volume was 90±150mL（average 115.7±15.2mL）. IPSS and OOL scores significantly decreased from 27.8±4.6 and 5.6_＋0.6 before op6ration to 6.6±4.3 and 2.8±0.8 at 3 months after operation（ P〈0.01）. Maximum urine flow rate（Qmax） significantly increased from （6.8±2.4）mL/s to （13.4±3.4）mL/s（ P d0.01）. Residual urine volume（PVR） significantly reduced from （68.5±12.4）mL to （18.5±3.6）mL, and there was significant difference between before and after operation（ P 〈 0.05）. No transurethral resection syndrome（TRUS） occurred. There was no death case. [Conclusion] PKVP has less bleeding, short operation time and high safety. Senior and high risk patients with BPH should not be considered as the contraindication of anesthesia and operation.