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目的总结高龄、高危良性前列腺增生患者经尿道等离子剜除术疗效。方法选择本科收治的高危、高龄良性前列腺增生患者167例,使用等离子电切镜进入膀胱,明确增生前列腺腺体,游离增生腺体至膀胱颈口后切除。结果 167例患者均顺利手术。手术时间38~117 min,平均58.2 min。电切前列腺组织称重33~68 g,平均49.3 g。术中出血量约50~200 ml,平均140 ml。手术患者术中及术后均未出现严重并发症,安全度过围手术期。术后随访患者行IPSS评分、残余尿、最大尿流率测定评估膀胱颈梗阻改善程度。结论高龄、高危不是前列腺手术的绝对禁忌证,充分的术前病情评估,加之相关疾病的有效控制可有效降低手术风险,并注意与患者及家属的沟通取得配合和理解,扩大了手术适应证。
Objective To summarize the efficacy of transurethral plasmapheresis in elderly patients and high-risk patients with benign prostatic hyperplasia. Methods A total of 167 patients with benign prostatic hyperplasia (BPH) were enrolled in this study. Plasma was used to enter the bladder. Prostate glands and hyperplastic glands were excised to the neck of the bladder. Results 167 patients were successfully operated. The operative time was 38 to 117 minutes, with an average of 58.2 minutes. Electrotome prostate tissue weighed 33 ~ 68 g, an average of 49.3 g. Intraoperative blood loss of about 50 ~ 200 ml, an average of 140 ml. No severe complications occurred during and after surgery in patients undergoing surgery, and the perioperative period was safe. Postoperative follow-up patients underwent IPSS score, residual urine, maximum urinary flow rate assessment of bladder neck obstruction to assess the extent of improvement. Conclusion The elderly and the high risk are not the absolute contraindications of prostate surgery. Adequate preoperative evaluation and effective control of the related diseases can effectively reduce the operation risk, and pay attention to the cooperation and understanding with the patients and their families to expand the indication of the operation.