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目的探讨高龄前列腺增生(BPH)患者采用分区法经尿道双极等离子切除治疗的效果及围手术期的安全性处理。方法 2006年6月至2013年1月应用分区法经尿道双极等离子切除治疗80岁以上前列腺增生患者81例,患者平均年龄85.1岁,>85岁36例;合并高血压病65例,冠心病50例,陈旧性心肌梗死7例,脑血管意外后遗症12例,慢性支气管炎、肺气肿49例,糖尿病35例。并收集患者术前、术后资料和症状评分进行对照。结果本组81例患者,其中72例均安全实施手术,手术时间17~94 min,失血量50~250 ml。术后随访12个月,没有出现尿失禁,最大尿流率(Qmax)由术前(4.3±3.1)ml/s上升至(14.4±3.2)ml/s,残余尿量(RUV)由术前(114.4±21.2)ml降至术后(26.7±9.2)ml,国际前列腺症状评分(IPSS)由术前(27.8±4.7)分降至术后(9.1±2.3)分,生活质量评分由术前的(5.6±1.1)分降至术后的(2.9±0.6)分,术后与术前比较均有统计学差异(P均<0.05)。结论高龄不是前列腺的手术禁忌,分区法经尿道双极等离子前列腺切除是治疗高龄前列腺增生有效、安全的方法。
Objective To investigate the effect and perioperative safety of transurethral bipolar plasmapheresis in elderly patients with benign prostatic hyperplasia (BPH). Methods From June 2006 to January 2013, 81 patients with benign prostatic hyperplasia (BPH), 80 years of age or older were enrolled in this study. The mean age was 85.1 years (range, 36 years) and 85 years old. Sixty-five patients with coronary heart disease 50 cases, 7 cases of old myocardial infarction, cerebral vascular accident sequelae in 12 cases, chronic bronchitis, emphysema in 49 cases, 35 cases of diabetes. Preoperative and postoperative data and symptom scores were collected for comparison. Results The group of 81 patients, of which 72 cases were safely performed surgery, operation time 17 ~ 94 min, blood loss 50 ~ 250 ml. The patients were followed up for 12 months without urinary incontinence. The Qmax increased from (4.3 ± 3.1) ml / s to (14.4 ± 3.2) ml / s preoperatively and the residual urine volume (RUV) (114.4 ± 21.2) ml to (26.7 ± 9.2) ml postoperatively, IPSS decreased from 27.8 ± 4.7 to 9.1 ± 2.3, and the quality of life score decreased from preoperative (5.6 ± 1.1) points postoperatively to (2.9 ± 0.6) points postoperatively compared with those before surgery were statistically significant (all P <0.05). Conclusion elderly is not a taboo of prostate surgery, regional transurethral bipolar plasma prostatectomy is an effective and safe treatment of elderly patients with benign prostatic hyperplasia.