前列腺增生症合并肾功能不全40例治疗体会

目的探讨前列腺增生症（BPH）合并肾后性肾功能不全的临床疗效。方法 40例合并慢性肾功能不全的前列腺增生症患者,通过留置尿管或耻骨上膀胱造瘘尿液引流,在肾功能改善后行耻骨上经膀胱前列腺切除术或经尿道前列腺汽化电切术。结果本组持续尿液引流,纠正酸碱度失衡及水电解质紊乱,恢复全身状况后,肾功能均有显著恢复。20例行开放性前列腺切除术,15例经尿道行前列腺汽化电切术,均顺利完成手术。术后随访1年～5年,残余尿0～30mL;血肌酐（Cr）36例在正常范围,4例在250～45μ0mol/L.结论尿液引流为手术创造条件,术前尽可能纠正肾功能不全,改善机体状况是手术成功的关键,行前列腺摘除术可有效改善临床症状及肾功能。

Experience of treating 40 cases of patients with benign prostate hyperplasia with chronic renal failure

Objective To evaluate the safety and therapeutic effects of surgery treatment of the patients with benign prostate hyperplasia （BPH）complicated with chronic renal failure. Methods The patients （40 cases）of BPH complicated with chronic renal failure were included in this study. All patients received urinary diversion and renal function recovered before modification of super pubic prostatectomy or transurethral vaporisation of prostate（TUVP）. Results Renal function in all patients had significant improvement after urinary diversion. The operations courses steady. All patients have been followed up for1-5 years and the result is satisfactory. Conclusion Urinary diversion creates chance for surgery treatment. It is key to operate successfully that improving patients＇s renal function and general statues actively before surgery treatment. Clinical symptoms and renal of all patients have significant improvement after prostatectomy.