中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
19期
3456-3461
,共6页
朱志强%张愚%韩志友%李响%马雪涛%吴振起%刘建威%郑鑫%高文锋%李琰峰
硃誌彊%張愚%韓誌友%李響%馬雪濤%吳振起%劉建威%鄭鑫%高文鋒%李琰峰
주지강%장우%한지우%리향%마설도%오진기%류건위%정흠%고문봉%리염봉
前列腺增生%老年人,80以上%经尿道前列腺切除术%等离子体
前列腺增生%老年人,80以上%經尿道前列腺切除術%等離子體
전렬선증생%노년인,80이상%경뇨도전렬선절제술%등리자체
Prostatic hyperplasia%Aged,80 and over%Transurethral resection of prostate%Plasmakinetic
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。
目的：探討高齡前列腺增生（BPH）患者採用分區法經尿道雙極等離子切除治療的效果及圍手術期的安全性處理。方法2006年6月至2013年1月應用分區法經尿道雙極等離子切除治療80歲以上前列腺增生患者81例，患者平均年齡85.1歲，＞85歲36例；閤併高血壓病65例，冠心病50例，陳舊性心肌梗死7例，腦血管意外後遺癥12例，慢性支氣管炎、肺氣腫49例，糖尿病35例。併收集患者術前、術後資料和癥狀評分進行對照。結果本組81例患者，其中72例均安全實施手術，手術時間17～94 min，失血量50～250 ml。術後隨訪12箇月，沒有齣現尿失禁，最大尿流率（Qmax）由術前（4.3±3.1）ml/s上升至（14.4±3.2）ml/s，殘餘尿量（RUV）由術前（114.4±21.2）ml降至術後（26.7±9.2）ml，國際前列腺癥狀評分（IPSS）由術前（27.8±4.7）分降至術後（9.1±2.3）分，生活質量評分由術前的（5.6±1.1）分降至術後的（2.9±0.6）分，術後與術前比較均有統計學差異（P均＜0.05）。結論高齡不是前列腺的手術禁忌，分區法經尿道雙極等離子前列腺切除是治療高齡前列腺增生有效、安全的方法。
목적：탐토고령전렬선증생（BPH）환자채용분구법경뇨도쌍겁등리자절제치료적효과급위수술기적안전성처리。방법2006년6월지2013년1월응용분구법경뇨도쌍겁등리자절제치료80세이상전렬선증생환자81례，환자평균년령85.1세，＞85세36례；합병고혈압병65례，관심병50례，진구성심기경사7례，뇌혈관의외후유증12례，만성지기관염、폐기종49례，당뇨병35례。병수집환자술전、술후자료화증상평분진행대조。결과본조81례환자，기중72례균안전실시수술，수술시간17～94 min，실혈량50～250 ml。술후수방12개월，몰유출현뇨실금，최대뇨류솔（Qmax）유술전（4.3±3.1）ml/s상승지（14.4±3.2）ml/s，잔여뇨량（RUV）유술전（114.4±21.2）ml강지술후（26.7±9.2）ml，국제전렬선증상평분（IPSS）유술전（27.8±4.7）분강지술후（9.1±2.3）분，생활질량평분유술전적（5.6±1.1）분강지술후적（2.9±0.6）분，술후여술전비교균유통계학차이（P균＜0.05）。결론고령불시전렬선적수술금기，분구법경뇨도쌍겁등리자전렬선절제시치료고령전렬선증생유효、안전적방법。
Objective To assess the safety and efficacy of sectionalized transurethral plasmakinetic resection of prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH) in advanced age. Methods Clinical data of 81 BPH patients at high risk with average age of 85.1 years, ranging from 80.1 to 93 years, undergoing sectionalized PKRP in our department from June 2006 to January 2013 were collected and retrospectively analyzed. During the operations, 9 (11.1%) patients’ surgery were suspended because of the high difficulty of the surgery. The safety of sectionalized PKRP was evaluated. All patients were followed up, with the times ranging from 6 to 90 months. Parameters of urination were measured before PKRP and at 6 months after operation. Results The duration of procedure was (58±21)min ranging from 17 to 94 min;The blood loss was 50 to 250 ml. There was no case requiring blood transfusion. All the 81 patients were followed up for 6 months at least, and no urinary incontinence was found after the operation. Compared with presurgical indicators, the peak flow rate (Qmax) was increased from (4.3±3.1)ml/s to (15.4±3.2)ml/s, while the international prostate symptom score (IPSS) was decreased from 27.8±4.7 to 9.1±2.3, the quality of life (QOL) from 5.6±1.1 to 2.9±0.6, and the residual urine volume (RUV) from (114.4±21.2)ml to (26.4±9.5)ml, respectively, 6 months postoperatively (all P<0.05). Conclusion Prostate surgery in advanced age patients is not a contraindication, strict perioperative management helps senior patients tolerate surgery smoothly. Sectionalized PKRP is a safe and effective treatment for BPH patients, especially for the advanced age patients.
