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目的:在西宁地区特定的高海拔环境下(海拔2 260m)对前列腺增生症(BPH)合并高原心脏病的高危患者选择合理、安全而切实有效的处置方法,从而解决患者排尿困难症状。方法:在限定的30分钟时间内,以快速、简捷的方法解决高危前列腺增生症膀胱出口梗阻(BOO)。对不能耐受手术、麻醉的高危患者根据具体情况实施“通道法”前列腺汽化电切术、耻骨上膀胱穿刺造瘘术以及应用药物并前列腺高频电容场保守治疗。结果:本组62例中,43例实施TUVRP术(经尿道等离子体前列腺汽化电切术);12例实施“通道法”前列腺汽化电切术;5例行耻骨上膀胱穿刺造瘘术;2例应用药物并前列腺高频电容场保守治疗。结论:在西宁地区特定的高海拔环境下强调充分的围手术期准备及治疗和预防,采用简捷、快速有效的切割方式(TUVRP),即能达到对合并高原心脏病的高危前列腺增生症的良好治疗效果。
OBJECTIVE: To choose reasonable, safe and effective treatment for high-risk patients with benign prostatic hyperplasia (BPH) complicated by heart disease under special high-altitude environment in Xining (elevation 2 260 m) in order to solve the symptoms of dysuria. Methods: In a limited 30-minute period, bladder outlet obstruction (BOO) in high-risk benign prostatic hyperplasia was solved in a quick and easy way. High-risk patients who can not tolerate surgery and anesthesia, according to the specific circumstances of the implementation of “channel method ” prostate electrovaporization, suprapubic bladder puncture fistula and the application of drugs and conservative treatment of high-frequency capacitance field prostate. Results: TUVRP was performed in 43 of the 62 cases (transurethral vaporization of the prostate); 12 cases were treated with “prostate” electrovaporization; 5 cases were treated with suprapubic bladder puncture ; 2 cases of drugs and conservative treatment of high-frequency capacitance field prostate. CONCLUSIONS: Adequate perioperative preparation, treatment and prevention are emphasized under the specific high altitude environment in Xining. The simple, rapid and effective cutting method (TUVRP) can be used to achieve high risk for benign prostatic hyperplasia treatment effect.