前列腺电气化和开放切除对80岁以上BPH疗效比较

Camparison of efficiety of TELVPand open prostatectomy in the over 80-year-old patients

目的 比较80岁以上前列腺切除的2种手术的疗效比较。方法 42例80岁以上前列腺增生(BPH)患者,A组25例行经尿道前列腺电气化切除术(腔内手术组);B组17例行经膀胱前列腺切除术(开放手术组)。用改良的possum评分系统对两组患者手术高危度和术前术后生理学评分变化以及各组切除的前列腺体积、手术时间、出血量、高龄对手术的耐受力、术后住院日、住院费等指标的平均值综合评价。结果 A组手术严重度评分9.04±0.20;B组10.82±0.81,P<0.001,有显著性差异。手术后生理学评分升高幅度A组1.1±2.3;B组2.2±3.5,P(0.001,差异有显著性。切除的前列腺体积A组(14.42±5.28)mL;B组(82.76±36.58)mL,P(0.001,有显著性差异。结论 前列腺电气化切除及经膀胱前列腺切除均适用于80岁以上BPH患者,前列腺偏小,腔内手术为首选;腺体偏大,或膀胱结石和较大膀胱憩室并存时,开放手术也是一种行之有效的手术方法。

AIM To compare the efficiety of TUVP and open prostatectomy in the over 80-year-old patients. METHOD A total of 42 patients with benign prostate hyperplasia(BPH) over 80(mean age 82.3.rang 80-89) had been divided into group A and group B. 25 of which was treated with transurethral electrovaperization(TUVP) in group A, 17 of which was treated with transvesical prostatectomy in group B. The physiology and operative high risk severity score was evaluated before and after operation with modified Possum Surgical Scoring System for each patient. According to the size of prostate resected, operative time, the quantity of bleeding during operation, the length of hospital stay and the costs of hospital stay, the capability of both the prostatectomy for the patients over the age of 80 was evaluated. RESULT In the group A, the operative high risk severity scores of scoring system were significantly lower than that in the group B. The level of physiological score of possum scoring system elevated after operation in group A was lower than that in group B. The size of prostate resected in group A and B were 14(82.76±36.58)mL, respectively P<0.001. There were no severe complication and post-operative deaths.CONCLUSION Both transurethral electrovaperization prostatectomy and transvesical prostatectomy can be used to treat BPH in the over 80-year-olds,But the operative high risk severity was higher in group B than that in group A. It was the first chose of Tuvp that when the prostate was small, while the prostate was large and cystolithiasis or Bladder diverticulum that cannot be treated transurethrally, the open surgery was also safety used to treat BPH in the over 80-year-old.