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目的:加深对高龄前列腺增生症的认识,提高其治疗水平。方法:对1985年1月～2000年2月期间我院手术治疗的59例高龄前列腺增生症的临床资料进行回顾性分析。结果:本组病例中急性尿潴留史者36例,留置导尿管者11例,行耻骨上膀胱造瘘者5例。术前残余尿量>50ml者5例。合并膀胱憩室、膀胱结石、腹外疝、肾功能不全分别有3,25,11和15例。59例患者均在硬脊膜外麻醉下施行手术治疗。术后停留导尿管4～12d,平均7.6d。术后发生心脏并发症3例,肺部感染4例,附睾炎2例,切口感染3例,前列腺窝出血和暂时性尿失禁各1例。52例获随访（1～8年）,26.9％的患者仍有程度不等的排尿障碍症状。结论:高龄前列腺增生症患者病程长,逼尿肌功能受损较严重,且较多合并其它脏器功能异常。术前应认真选择和准备病人,尽可能采用连续硬脊膜外麻醉,术中严密监护,手术操作应轻、快、巧,术后针对高龄患者的特点加强观测及护理,防止并发症的发生。
Objective: To deepen the understanding of elderly patients with benign prostatic hyperplasia and improve their treatment level. Methods: The clinical data of 59 cases of benign prostatic hyperplasia (BPH) treated surgically in our hospital from January 1985 to February 2000 were analyzed retrospectively. Results: The group of patients with acute urinary retention in 36 cases, indwelling catheter in 11 cases, suprapubic bladder ostomy in 5 cases. Preoperative residual urine volume> 50ml in 5 cases. Bladder diverticulum, bladder stones, abdominal hernia, renal insufficiency, respectively, 3,25,11 and 15 cases. All 59 patients underwent surgical treatment under epidural anesthesia. Postoperative catheter 4 ~ 12d, an average of 7.6d. Postoperative cardiac complications occurred in 3 cases, 4 cases of pulmonary infection, 2 cases of epididymitis, incision infection in 3 cases, prostate hemorrhage and temporary urinary incontinence in 1 case. Of the 52 patients who were followed up (1-8 years), 26.9% of patients had varying degrees of dysuria symptoms. Conclusion: Patients with advanced benign prostatic hyperplasia have long course of disease, detrusor dysfunction is more serious, and more with other organ dysfunction. Preoperative patients should be carefully selected and prepared, as far as possible with continuous epidural anesthesia, intraoperative intensive care, surgical operation should be light, fast, clever, postoperative patients with advanced features to strengthen the observation and care to prevent the occurrence of complications .