高龄老年良性前列腺增生患者临床特征和经尿道前列腺电汽化切除术疗效

目的探讨80岁以上高龄老年良性前列腺增生（BPH）手术患者的临床特征和经尿道前列腺电汽化切除术（TUVRP）的疗效。方法回顾性分析285例TUVRP诊疗过程，按年龄分成3组：A组91例，年龄〈70岁；B组127例，年龄71～79岁；C组67例，年龄〉80岁。结果术前A组前列腺重量（53．15±24．15）g，B组（67．83±39．73）g（与A组相比，P〈0．05），C组（60．00±43．86）g。A组伴有BPH并发症74例（81．32％），B组109例（85．83％），C组59例（88．06％）（P〉0．05）。A组伴有影响排尿功能疾病18例（19．78％），B组13例（10．24％），C组14例（20．90％）（P〉0．05）。C组伴有内科全身性疾病多于其他两组（P〈0．001）；ASA体格情况分级随年龄增高而增加（P〈0．001）；术前和术后Hgb含量随年龄增高而减少（P〈0．01）。手术时间、术后膀胱持续冲洗人数和天数、术后国际前列腺症状（IPSS）评分和生活质量（QOL）指数差异无显著性（P〉0．05）。术后最大尿流率和平均尿流率随年龄增高而减少（P〈O．01）。结论伴随着老年男子的衰老进程前列腺体积逐年增大，到中龄老年时可能已达到峰值。高龄老年不会加大手术操作难度，但是可以降低患者身体素质，选择治疗方案时应注意膀胱逼尿肌功能。TUVRP可以有效改善高龄老年BPH的临床症状。

The clinical feature of advanced aged patients with benign prostatic hyperplasia and the efficiency of transurethral vaporization resection of the prostate

Objective To evaluate the clinical feature of patients aged over 80 with benign prostatic hyperplasia （BPH） and the efficiency of transurethral vaporization resection of the prostate （TUVRP） to treat BPH. Methods The clinical procedure of 285 cases treated by TUVRP was retrospectively analyzed and the patients were divided into three groups. Group A included 91 cases younger than 70 years old, Group B 127 cases aged between 71-79 years old and Group C 67 cases older than 80 years old. Results Preoperative prostate weight was （53.15±24.15）g in Group A, （67.83!39.73）g in Group B （compared with Group A, P〈0. 05） and （60.00±43.86）g in Group C. 74 cases （81.32%） in Group A, 109 cases （85.83%） in Group B and 59 cases （88.06%） in Group C had complications associated with BPH （P〉0. 05）. 18 cases （19.78%） in Group A, 13 cases （10.24%） in Group B and 14 （20.90%） in Group C had accompanied diseases with impact to urinary function （P〉0. 05）. Accompanied systemic diseases of internal medicine were more in Group C than in other two groups （P〈 0. 001）. American Society of Anesthesiologists （ASA） grade was increased with advance of age （P〈0. 001）. Preoperative and postoperative hemoglobin levels decreased with advance of age （P 〈 0. 01）. Operating time, the case and time with postoperative continuous bladder irrigation, IPSS score and QOL index had no significant difference among the three groups （P〉0.05）. Maximum and mean urinary flow rate decreased with advance of age （P〈0. 01）. Conclusion It suggests that the prostate volume of aged male will increase with the aging process; however, the volume may reach its peak in medium aged patients. Advanced age does not make it more difficult to perform the procedure, but will reduce the physical quality. We should pay more attention to the function of bladder detrusor when making a decision about treatment options. TUVRP can effectively improve clinical symptoms of advanced aged patients.