经尿道前列腺气化电切术治疗高龄、高危良性前列腺增生疗效分析

Ananlysis of the effect and safety of transurethral vaporization of the prostate in the treatment of advanced age and high risk patients with benign prostatic hyperplasia

目的：观察经尿道前列腺气化电切（ TUVP）治疗高龄、高危良性前列腺增生（ BPH）患者的疗效及安全性。方法回顾性分析47例在经尿道汽化电切治疗的高龄、高危BPH患者临床资料，分析围手术期并发症发生率，比较手术前、后前列腺症状评分（IPSS）、残余尿量（RUV）、最大尿流率（Qmax）及生活质量评分（QOL）。结果47例患者手术时间57～214 min，平均（95．2±36．7）min，切除前列腺腺体重量31～69 g，平均（39．8±10．3）g，术中未出现闭孔反射或电切综合征。3例患者出现尿路感染，无真性尿失禁发生。术后3个月与术前比较，患者最大尿流率[（26．5±2．8）mL/s与（8．4±1．3）mL/s，t＝11．32，P＜0．01]得到显著改善，残余尿量降低[（7．3±1．2）mL与（2．8±0．3）mL，t＝4．36，P＜0．05]，IPSS[（170．9±121．5）分与（25．5±10．0）分，t＝18．29，P＜0．01]、QOL评分[（8．1±2．5）分与（15．2±2．6）分，t＝8．54，P＜0．05]增加。结论高龄BPH患者可耐受经尿道前列腺气化电切术，围手术期无严重并发症发生，术后BPH症状获得显著改善。

Objective To observe the effect and safety of transurethral vaporization of the prostate（ TURP） in the treatment of advanced age and high risk patients with benign prostatic hyperplasia（ BPH） .Methods Clinical data of 47 advanced age and high risk patients with BPH which were treated with TURP were retrospectively analyzed. The operation time, blood loss and surgical complications were observed.Before and after surgery, the international prostate symptom score（ IPSS） ,quality of life score（ QOL） ,residual urine volume（ PVR） ,maximum urinary flow rate （ Qmax） were recorded and analyzed at the same time.Results 47 patients operation time was 57~214 min,mean time was （95.2 ±36.7） min.There was none obturator nerve reflex or TURP syndrome happened.And 3 patients had urinary tract infection post-operation,and none had real urinary incontinence.Compared to pre-operation,3 months af-ter operation,Qmax[（26.5 ±2.8） vs（8.4 ±1.3）,t =11.32,P〈0.01] were improved obviously,RUV[（7.3 ± 1.2）vs（2.8 ±0.3）,t=4.36,P〈0.05]decreased,the IPSS[（170.9 ±121.5）vs（25.5 ±10.0）,t=18.29,P〈0.001]and QOL[（8.1 ±2.5）vs（15.2 ±2.6）,t=8.54,P〈0.05]were increased.Conclusion TURP is safe and effective therapy in advanced age and high risk patients with BPH and the syndrome could be improved obviously.