个体化TURP治疗高危良性前列腺增生症的临床观察

目的 探讨个体化方案治疗高危良性前列腺增生症的临床效果及安全性.方法 对87例高危良性前列腺增生症患者进行个体化围手术期处理,采用标准TURP(22例),低容量大通道TURP(37例),低容量小通道TURP(28例)手术治疗,观察手术治疗效果及安全性.方法 全部病例均顺利耐受手术,无严重并发症,无输血病例.标准TURP组、低容量大通道TURP组和低容量小通道TURP组平均手术时间分别为(65.5±21.2)、(32.4±17.5)、(16.5±3.6)min;术中平均失血量分别为(148.4±45.3)、(84.7±37.2)、(32.4±15.7)ml;平均切除组织量分别为(41.2±10.5)、(25.4±6.3)、(11.3±3.2)g.与标准TURP组相比,有显著差异(p<0.05).所有病例随访3～28个月,IPSS评分分别降低(19.7±6.8)、(17.9±6.4)、(15.7±9.5);最大尿流率分别增加(13.4±8.4)、(12.7±9.4)、(11.4±5.4)ml/s;生活质量评分分别下降(2.2±0.2)、(2.1±0.2)、(2.4±0.4);剩余尿量分别下降(135.7±68.4)、(158.8±87.5)、(147.6±65.7)ml.组间疗效比较无显著差异(p>0.05).结论 个体化围手术期治疗和个体化TURP是治疗高危良性前列腺增生症的安全有效方法 ,值得推广.

Outcome of high risk BPH patients treated with individual TURP

Objectives To evaluate the clinical efficacy and safety of individual treatment for BPH at high risk. Methods Under the individual treatment during perioperative period,87 high risk patients with BPH received standard TURP(Group 1,n=22),low-volume large passage TURP(Group 2,n=37) or low-volume small passage TURP(Group 3,n=28).Evaluate the efficacy and safety.Results All patients were tolerable for the operations without serious complications, no blood transfusion.In groups 1,2 and 3,the mean operation time was (65.5±21.2),(32.4±17.5)and(16.5±3.6)min; blood loss was (148.4±45.3),(84.7±37.2)and(32.4±15.7)ml; resected tissue weight was (41.2±10.5),(25.4±6.3)and(11.3±3.2)g, Which showed significant difference compared with Group 1(p<0.05). At the 3 to 28 months following up, IPSS change (19.7±6.8),(17.9±6.4)and(15.7±9.5);Qmax (13.4±8.4),(12.7±9.4)and(11.4±5.4)ml/s; QOL (2.2±0.2),(2.1±0.2)and(2.4±0.4);RUV (135.7±68.4),(158.8±87.5)and(147.6±65.7)ml respectively (p>0.05).Conclusions The individual perioperative treatment and the individual TURP are effective and safe method for the treatment of BPH patient with high risk.