分期经尿道等离子电切治疗高龄高危重度前列腺增生

Transurethral plasmakinetic resection by stage for senile high risk and large volume benign prostatic hyperplasia

目的:探讨分期经尿道前列腺等离子电切在高龄、高危、重度良性前列腺增生患者中应用的安全性和有效性。方法:回顾性分析分期经尿道等离子电切术治疗高龄、高危、重度前列腺增生患者83例的临床资料,比较术前术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(RUV)及最大尿流率(Qmax)变化以及手术并发症的发生率。结果:所有患者术后随访1～12个月,与术前相比,术后国际前列腺症状评分(IPSS)(5.8±1.2 vs.26.3±4.5)、生活质量评分(QOL)(1.1±0.7 vs.4.8±0.7)、残余尿量(RUV)(20±12.5 vs.245±80)及最大尿流率(Qmax)(20.0±3.5vs.4.5±2.2)较术前显著改善,差异有显著性(P值均<0.05),无电切综合症及死亡病例,无真性尿失禁、输血及膀胱穿孔发生。结论:分期经尿道等离子电切术治疗高龄高危重度前列腺增生患者具有安全性高、并发症少、疗效确切等优点。

Objectives： To discuss and summarize the safety, efficacy and treatment experience of transurethral plasmakinetic resection by stage for senile high risk and large volume benign prostatic hyperplasia. Methods： The data of 83 cases of senile high risk and large volume benign prostatic hyperplasia treated by transurethral plasmakinetic resection was retrospective analysised. Results： All patients were followed up for 1 month to 12 months. The international prostate symptom scores （ IPSS）, quality of life （QOL）, maximal flow rate （Qmax） and residual urine volume （RUV） were significantly improved than those of preoperation, and the differences were significant. All patients underwent safely. There was no complications such as transurethral resection syndrome, real urinary incontinence, blood transfusion and bladder perforation. Conclusion： The way of ransurethral plasmakinetic resection by stage for senile high risk and large volume benign prostatic hyperplasia has advantages of less bleeding and complications, and is considered as a safe and effective treatment.