CAJ | 학술논문

目的评估85岁以上超高龄BPH患者经尿道前列腺电汽化切除术(TUVRP)的手术风险和术后生存状态.方法55例85岁以上施行TUVRP患者(A组)与228例80岁以下患者(B组和C组)进行回顾性比较.A组55例85~97岁,平均年龄(87.91±2.70)岁;B组137例71~80岁;C组91例60~70岁.结果美国麻醉学会(ASA)评分A组高于B组和C组,与B组和C组相比,差异均具统计学意义(P≤0.05);手术时间A组为(40.03±18.90) min,与B组和C组比较差异无统计学意义(P>0.05).A组术后34例存活者日常生活和行为能力(Barthel)指数(66.0±17.46),其中18例(52.94%)评分>60;10例(29.41%)评分41~60;6例(17.65%)评分<40.A组31例国际前列腺症状评分(IPSS)11.35±7.04,与B组比较差异无统计学意义(P>0.05).与C组相比具统计学意义(P<0.01).生活质量评分(QoL)1.23±0.76,均低于B组和C组,差异均具统计学意义P<0.05.结论85岁以上BPH患者手术风险高于80岁以下.大部分患者术后可获得满意排尿功能和保持较好的日常生活能力.一次安全的TUVRP手术能够改善85岁以上BPH患者的日常生活能力和生活质量.
목적평고85세이상초고령BPH환자경뇨도전렬선전기화절제술(TUVRP)적수술풍험화술후생존상태.방법55례85세이상시행TUVRP환자(A조)여228례80세이하환자(B조화C조)진행회고성비교.A조55례85~97세,평균년령(87.91±2.70)세;B조137례71~80세;C조91례60~70세.결과미국마취학회(ASA)평분A조고우B조화C조,여B조화C조상비,차이균구통계학의의(P≤0.05);수술시간A조위(40.03±18.90) min,여B조화C조비교차이무통계학의의(P>0.05).A조술후34례존활자일상생활화행위능력(Barthel)지수(66.0±17.46),기중18례(52.94%)평분>60;10례(29.41%)평분41~60;6례(17.65%)평분<40.A조31례국제전렬선증상평분(IPSS)11.35±7.04,여B조비교차이무통계학의의(P>0.05).여C조상비구통계학의의(P<0.01).생활질량평분(QoL)1.23±0.76,균저우B조화C조,차이균구통계학의의P<0.05.결론85세이상BPH환자수술풍험고우80세이하.대부분환자술후가획득만의배뇨공능화보지교호적일상생활능력.일차안전적TUVRP수술능구개선85세이상BPH환자적일상생활능력화생활질량.
Objective To evaluate surgical risk of transurethral vaporization resection of the prostate (TUVRP) and postoperative quality of living status in patients over 85 years of age with benign prostate hyperplasia (BPH). Methods Fifty five patients over 85 years old with BPH who underwent TUVRP were compared with 228 patients below 80 years old. There were 55 patients aged from 85 to 97 years old, with mean age 87.91± 2.70 years in Group A , 137 patients aged from 71 to 80 year old in Group B, and 91 patients aged from 60 to 70 year old in Group C. Results Preoperative ASA grade in Group A was higher than that of the other two groups (P≤0.05), but no obvious difference in operating time ( 40.03± 18.90)min (P >0.05). Follow-up was obtained in 44 (80.00%) patients; of them 10 patients were deaths with a survival time of 22.90 ± 11.14 months. For 34 survivors in groupA, barthel index score was 66.03±17.46, and for 18 of them (52.94%), score was >60; Score of 10 (29.41%) patients was 41-60 and 6 (17.65%) patients was <40. IPSS score of 34 patients in group A was 11.35±7.04, there was a significant difference in IPSS score compared with that of Group C (P<0.01). QOL index was 1.23±0.76, there was a significant differnece compared with that of the other two groups (P<0.05). Conclusion TUVRP surgical risk in patients over 85 years old is higher than that in patients below 80 years old. But most patients over 85 years old had satisfactory voiding function and better activities in daily living after TUVRP. A safety TUVRP could improve their activities of daily living and quality of life.