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目的讨论采用经尿道前列腺电切术(TURP)治疗高龄高危前列腺增生症患者的手术安全性和治疗效果。方法术前采用个体化方式方法,根据患者的实际病情评估手术的风险性,针对性地调整围手术期的治疗,行TURP治疗高龄高危前列腺增生症患者56例。结果全部患者均安全耐受手术、度过围手术期并获得满意的疗效,随访2~18个月,排尿通畅,国际前列腺症状评分(IPSS)示术后评分较术前明显下降(8.2±1.8 vs 25.5±1.4,P<0.01),残余尿量(PVR)明显下降〔(22.0±3.0)vs(82.3±5.0)ml,P<0.01〕。结论重视及加强围手术期处理,针对高龄高危前列腺增生症患者行TURP治疗是可行的,手术安全,疗效满意。
Objective To discuss the safety and efficacy of transurethral resection of the prostate (TURP) in the treatment of elderly patients with high-risk benign prostatic hyperplasia. Methods Fifty-six patients with high-risk benign prostatic hyperplasia (BPH) were treated with TURP in an individualized manner. The risk of surgery was evaluated according to the actual condition of the patients and the perioperative treatment was adjusted accordingly. Results All patients were safe and tolerant to surgery, perioperative and had satisfactory curative effect. The patients were followed up for 2 to 18 months and their voiding was unobstructed. The International Prostate Symptom Score (IPSS) showed a significant decrease in postoperative scores (8.2 ± 1.8 vs 25.5 ± 1.4, P <0.01). Residual urine volume (PVR) decreased significantly [(22.0 ± 3.0) vs (82.3 ± 5.0) ml, P <0.01〕. Conclusion It is feasible to emphasize and strengthen the perioperative management for TURP in elderly patients with high risk of benign prostatic hyperplasia. The operation is safe and the curative effect is satisfactory.