经尿道双极等离子汽化电切术治疗高危重度前列腺增生

目的探索经尿道双极等离子汽化电切术在高危、重度前列腺增生患者中的安全性及其临床疗效,总结术前准备注意事项、术中手术技巧及术中监测的临床经验。方法回顾性分析85例高危重度前列腺增生(BPH)患者行经尿道双极等离子汽化电切术(TUPVP)的临床资料,观察该手术对于高危重度BPH患者的临床疗效及手术并发症的发生情况。结果手术时间50～135min,平均58±16 min;切除腺体重量16～56 g,平均31.6±9 g;术中出血量50～400 ml,平均110±36 ml。术前中心静脉压7.5±2.5 cmH2O,术中最高中心静脉压10.5±3.4 cmH2O,术后中心静脉压7.6±2.6 cmH2O。平均随访12个月,患者国际前列腺症状评分(IPSS)由25.1±2.9分降至7.2±3.2分,残余尿量由305±35 ml降至32±8 ml,最大尿流率由8.0±3.1 ml/s升至25.7±4.2 ml/s。结论经尿道双极等离子汽化电切术治疗高危重度前列腺增生安全、有效。充分的术前准备,严格的术中、术后监护和护理以及个体化的手术方案是手术成功的关键。

The safety and efficacy of transurethral plasma kinetic vaporization prostatectomy in eld and high risk benign prostatic hy- perplasia

Objective To explore the safety and efficacy of transurethral plasma kinetic vaporization prostatectomy in eld and high risk benign prostatic hyperplasia(BPH)patients.Methods The clinical data of 85 old patients with high risk benign prostatic hyperplasia underwent transurethral vaporization of the prostate(TUVP)were analyzed retrospectively.The preoperative preparation, operation skills,postoperative complications were observed.The international prostate symptom score(IPSS),residual urine volume (RUV)and maximum urine flow rate(Qmax)before and after operation were compared.Results Surgery time was 50-135 min,average 58 min.The weight of the resected gland was 16-56 g,average 31.6±9 g.The volume of blood loss was 50-400 ml,average 110±36 ml.The central venous pressure(CVP)before operation was 7.5±2.5 cmH2O.The highest central venous pressure in operation was 10.5±3.4 cmH2O.The central venous pressure after operation was 7.6±2.6 cmH2O.The average follow-up visit time was 12 months.IPSS dropped from 25.3±2.9 to 7.2±3.2.RUV decreased from 305±35 ml to 32±8 ml.The Qmax increased from 8.0±3.1 ml/s to 25.7±4.2 ml/s.Conclusions Transurethral vaporization of the prostate in eld and high risk benign prostatic hyperplasia patients is safe and efficacious.