80岁以上老年人前列腺增生症开放手术效果评价

目的评价８０岁以上老年人前列腺增生症（ＢＰＨ）行前列腺开放手术的效果和安全性。方法回顾性分析１１７例８０～９１岁ＢＰＨ患者施行开放前列腺摘除术的临床资料和随访结果。结果开放手术的指征中，大体积前列腺引起尿潴留和严重排尿困难者７８例，合并膀胱结石２５例，前列腺出血９例，腹股沟疝７例，膀胱憩室５例。气管内插管全身麻醉８９例，连续硬膜外麻醉２８例。术中出血（４３０±２９２）ｍｌ。术中和术后无死亡和危及生命的并发症发生。术后排尿功能满意１１４例（９７４％），Ｍａｄｓｅｎ症状评分和最大尿流率及平均尿流率较术前均有显著改善。结论８０岁以上老年人施行前列腺开放摘除手术是安全的，效果是满意的。

Open prostatectomy in elderly patients

bjective To assess the results of open prostatectomy in patients with BPH older than 80 years old. Methods The materials of 117 patients 8091 years old undergone transvesical or retropubic prostatectomy between 1986 and 1997 were retrospectively analysed and followed up. Results The indications for surgery were urinary retention with a large prostate in 78 patients (667%),cystolithiasis in 25(214%),prostatic bleeding in 9(77%), hernia in 7(60%) and bladder diverticulum in 5(43%). A total of 89 patients (761%) underwent surgery under general anesthesia and 28(239%) received epidural anesthesia. No postoperative death or life threatening complications were noted. One hundred and fourteen patients (974%) had satisfactory voiding activity. The clinical symptom score, maximal flow rate and average flow rate were very significantly improved after operation. Conclusions Open prostatectomy can be performed safely in elderly patients with a satisfactory result.