经尿道前列腺剜除术联合膀胱小切口治疗高危大体积的前列腺增生

Combined transurethral enucleation and resection of the prostate and mini-incision percutaneous cystolithotomy for high-risk huge benign prostatic hyperplasia

目的探讨高龄、高危、大体积的前列腺增生安全、有效的手术方法。方法本组患者共85例，年龄75～91岁，先行经尿道前列腺剜除术，后在膀胱造瘘VI基础上行小切口膀胱切开取出剜除的前列腺组织。结果平均手术时间为（50±3）min，术中平均出血量（95±11）ml，前列腺重量平均（115±5）g。无围手术期死亡病例。IPSS评分由术前（29．4±2．9）分降为（8．2±1．2）分，QOL由（4．6±0．7）分降为（1．5±0．5）分，最大尿流率由（6．4±2．4）m1]s升为（15．8±3．0）ml／s，残余尿量由（137．0±15．8）ml降为（29．0±12．8）ml。术后随访时问6～12个月，患者生活质量明显提高。结论该方法是治疗高龄、高危、大体积的前列腺增生安全、有效的治疗方法。

Objective To explore a safe, effective, simple and practical surgery method for the patients with high-risk huge benign prostatic hyperplasia. Methods In this study, 85 patients with high-risk huge benign prostatic hyperplasia were performed with transurethral enucleation and resection of the prostate and the prostate tissues were removed from a bladder mini-incision, and the patients＇ age ranged from 75 to 91 years. Results The mean operation time was（50±3） minutes, the mean interoperation bleeding was（95±ll）ml. The resection tissues weighted（llS±5）g in average. No death occurred. IPSS decreased from （29.4±2.9） to （8.2±1.2）, QOL decreased from （4.6±0.7） to （1.5±0.5）, the maximum flow rate increased from （6.4±2.4）ml/s to （15.8±3.0）ml/s, post-void residual urine volume decreased from （137.0±15.8）ml to （29.0±12.8）ml. After operation, the follow-up time was 6 months to 12 months. The life quality of patients was improved significantly. Conclusions This method is safe and effective to the patients with high-risk huge benign prostatic hyperplasia.