【摘要】 目的:总结和探讨高龄良性前列腺增生(BPH)患者经尿道前列腺汽化电切术(TUVP)围手术期处理方法。方法:总结131例年龄75～88岁BPH患者施行TUVP的情况。手术前全面检查了解患者精神状况,自理能力;心脑血管疾病、呼吸系统疾病、脑血管疾病、糖尿病,甲状腺疾病等病史及用药情况。术前除常规检查肝肾功能,甲状腺功能,肺功能,心功能的测定以评估手术耐受能力及可能发生的并发症,注意心、脑、肺伴发病及糖尿病等围手术期处理。结果:128例一次拔管恢复排尿,3例(2.3%)拔管后再次尿潴留,保留导尿数日,2例痊愈。1例因膀胱收缩功能障碍长期耻骨上膀胱造瘘带管。本组术后2例(1.5%)继发出血经保守处理后痊愈。1例(0.7%)右下肢深静脉血栓形成,1例(0.7%)发生急性出血性胃炎。术后4例(3.0%)尿路感染,无经尿道电切综合征发生。无心脑血管疾病及呼吸系统并发症。3～6个月随访IPSS评分由25.24±4.70下降为7.81±4.12;QoL评分由4.51±0.72下降为1.51±0.73;最大尿流率由(10.14±6.31)ml/s上升为(18.14±4.12)ml/s。结论:经过良好的围手术期处理,高龄患者可以安全顺利地接受TUVP,减少手术并发症,提高康复质量。更多还原

【Abstract】 Objective:To investigate the perioperative treatment of senile patients with benign prostatic hyperplasia(BPH)undergoing transurethral electrovaporization of prostate(TUEVP).Methods:Totally 131 BPH patients aged 75-88 years underwent TUEVP,general data and past history of illness of the patients obtained before surgery,including their mental state,self-care ability,diseases of the cardiovascular,cerebrovascular and respiratory systems,diabetes mellitus,thyroid diseases and medication,and preoperative routine examinations performed on the functions of the kidneys,lungs,heart and thyroid gland to assess their operation-endurance,chances of complications and perioperative countermeasures.Results:Of the total number of patients,128 recovered urination and 3 relapsed into urinary retention after withdrawal of the cathither,with 2 restored to health.One patient had to carry the stomal tube because of bladder contraction dysfunction,2(1.5%)developed secondary bleeding but recovered after conservative treatment,1(0.7%)deep vein thrombus,1 acute hemorrhagic gastritis(0.7%)and 4(3.0%)postoperative urinary tract infection,but with no TUEVP syndrome and no complications of the cerebrovascular and respiratory systems.A 3-6 months follow-up showed that IPSS decreased from 25.24 ± 4.70 to 7.81 ± 4.12,QOL dropped from 4.51 ± 0.72 to 1.51 ± 0.73,and Qmax increased from(10.14 ± 6.31)ml/s to(18.14 ± 4.12)ml/s.Conclusion:By proper perioperative treatment,TUEVP could be safely and smoothly performed in senile BPH patients,with fewer complications and better recovery.更多还原