经尿道电切治疗高危前列腺增生症

目的探讨经尿道前列腺电切术（transurethral resection of the prostate,TURP）治疗高危前列腺增生（benign prostatic hyperplasia,BPH）的安全性和疗效。方法2001年1月-2007年7月对303例高危BPH（年龄65-89岁,平均76.3岁;合并心血管病151例,肺部疾病67例,糖尿病37例,脑部疾病26例,肾功能不全16例,肝功能异常6例）施行TURP。结果303例高危BPHTURP成功,术后排尿通畅,无死亡病例和严重并发症发生。术前与术后3个月比较：国际前列腺症状评分（IPSS）从（19.6±7.9）分下降至（6.4±3.3）分（t=26.838,P=0.000）,生活质量评分（QOL）从（4.7±1.5）分下降至（2.3±1.1）分（t=22.459,P=0.000）,最大尿流率（Qmax）从（4.1±2.6）ml/s升至（13.9±7.1）ml/s（t=-22.561,P=0.000）,残余尿（RU）从（139.0±32.5）ml下降至（13.5±8.6）ml（t=55.143,P=0.000）。结论TURP治疗高危BPH安全有效,并发症少,围手术期个体化处理和手术技巧是保证手术成功的关键。

Transurethra Resection of the Prostate for High-Risk Benign Prostatic Hyperplasia

Objective To evaluate the safety and efficacy of transurethral resection of the prostate （TURP） for high-risk benign prostatic hyperplasia （BPH）. Methods Form January 2001 to July 2007, we performed TURP on 303 patients with highrisk BPH. The patients aged form 65 to 89 years with a mean of 76. 3. Among them, 151 were complicated with cardiovascular diseases, 67 had pulmonary diseases, 37 had diabetes mellitus, 26 had brain disease, 16 showed renal inadequacy, and 6 showed abnormal liver function. Results The procedure was completed successfully in all of the 303 cases without death, dysuria, or severe complications. Compared to the examinations carried out before the procedure, the IPSS and QOL scores, and RU decreased significantly, while the Qmax increased 3 months after the prosedure [ IPSS： （19.6 ± 7.9） points vs. （6.4± 3.3 ） points, t = 26. 838, P=0. 000; QOL： （4.7±1.5） points vs. （2.3±1.1） points, t=22.459, P=0. O00; Qmax： （4.1 ±2.6） ml/s vs. （13.9±7.1） ml/s, t= -22.561, P =0.000; and RU： （139.0 ±32.5） ml vs （13.5 ±8.6） ml, t =55.143, P =0.000]. Conclusions TURP is a safet and effective procedure for high-risk BPH with a low rate of postoperative complications. Proper peri-operative individual management and operation skills are important for the success of the procedure.