高龄良性前列腺增生患者经尿道前列腺汽化电切术围手术期处理  

Perioperative Treatment of Senile Benign Prostatic Hyperplasia Patients Undergoing Transurethral Electrovaporization of Prostate

作　　者：丁毅[1] 张世革[1] 吴烨[1] 

机构地区：[1]江苏省老年医院泌尿外科,江苏南京210004

出　　处：《中华男科学杂志》2008年第10期920-922,共3页National Journal of Andrology

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。Objective： To investigate the perioperative treatment of senile patients with benign prostatic hyperplasia （BPH） undergo- ing 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 rou- tine 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 de- creased 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. Natl J Androl, 2008, 14 （10） ： 920-922

关 键 词：良性前列腺增生 高龄 经尿道前列腺汽化电切术 围手术期 

分 类 号：R697.32[医药卫生—泌尿科学]