低压灌注下经尿道分区等离子剜切治疗高龄高危前列腺增生

目的：探讨低压灌注下经尿道分区等离子剜切治疗高龄高危良性前列腺增生（ benign prostatic hyperplasia ， BPH）的疗效和安全性。方法2011年6月～2013年6月，对98例高龄高危BPH患者行耻骨上造瘘，冲洗液距病人腹部高度50 cm。膀胱处于半空虚状态，行四区剜切治疗。结果手术时间31～135 min，（54±11） min；切除组织26～82 g，（35．0±4．5）g；术中出血量25～225 ml，（125±22）ml；术后2～4 d拔导尿管。无并发症。术后3个月国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）及残余尿（PVR）均明显改善（P＝0．000）。结论低压灌注下经尿道分区等离子剜切治疗高龄高危BPH疗效确切，手术时间可控，安全性较高，值得推广。

A Clinical Research of Transurethral Plasmakinetic Resection under Low-pressure Perfusion for Elderly or High-risk Patients with Benign Prostatic Hyperplasia

Objective To investigate the effect and safety of transurethral plasmakinetic resection under low -pressure perfusion in the treatment of elderly or high-risk patients with benign prostatic hyperplasia （BPH）. Methods From June 2011 to June 2013, 98 cases of elderly patients with high-risk BPH underwent suprapubic fistulization .Flushing fluid was 50 cm above patients’ abdomen.The bladder was half emptied and plasmakinetic resection was done in four districts . Results The operative time was 31-135 min （average, 54 ±11 min）;resected tissue weighed 26-82 g （average, 35.0 ±4.5 g）;intraoperative blood loss was 25-225 ml （average, 125 ±22 ml）; postoperative catheterization lasted for 2-4 d.No postoperative complications occurred . International prostate symptom score （IPSS）, quality of life （QOL）, maximum flow rate （Qmax） and post-void residual urine volume （PVR） were significantly improved 3 months after the surgery （P=0.000）. Conclusion Transurethral plasmakinetic resection under low-pressure perfusion in the treatment of elderly or high-risk patients with BPH is safe and effective .