超高龄BPH患者的手术风险和术后生存状况  

Surgical risk and postoperative living status in very elderly patients with BPH

作　　者：张晔[1] 李爱华[1] 吴文美[1] 陆鸿海[1] 张峰[1] 刘思宽[1] 王晖[1] 钱小强[1] 张炳辉[1] 方炜[1] 

机构地区：[1]同济大学附属杨浦医院,上海市杨浦区中心医院,上海200090

出　　处：《中国男科学杂志》2013年第4期46-49,共4页Chinese Journal of Andrology

摘　　要：目的评估85岁以上超高龄BPH患者经尿道前列腺电汽化切除术（TUVRP）的手术风险和术后生存状态.方法55例85岁以上施行TUVRP患者（A组）与228例80岁以下患者（B组和C组）进行回顾性比较.A组55例85~97岁,平均年龄（87.91±2.70）岁;B组137例71~80岁;C组91例60~70岁.结果美国麻醉学会（ASA）评分A组高于B组和C组,与B组和C组相比,差异均具统计学意义（P≤0.05）;手术时间A组为（40.03±18.90） min,与B组和C组比较差异无统计学意义（P〉0.05）.A组术后34例存活者日常生活和行为能力（Barthel）指数（66.0±17.46）,其中18例（52.94%）评分〉60;10例（29.41%）评分41~60;6例（17.65%）评分〈40.A组31例国际前列腺症状评分（IPSS）11.35±7.04,与B组比较差异无统计学意义（P〉0.05）.与C组相比具统计学意义（P〈0.01）.生活质量评分（QoL）1.23±0.76,均低于B组和C组,差异均具统计学意义P〈0.05.结论85岁以上BPH患者手术风险高于80岁以下.大部分患者术后可获得满意排尿功能和保持较好的日常生活能力.一次安全的TUVRP手术能够改善85岁以上BPH患者的日常生活能力和生活质量.Objective To evaluate surgical risk of transurethral vaporization resection of the prostate （TUVRP） and postoperative quality of living status in patients over 85 years of age with benign prostate hyperplasia （BPH）. Methods Fifty five patients over 85 years old with BPH who underwent TUVRP were compared with 228 patients below 80 years old. There were 55 patients aged from 85 to 97 years old, with mean age 87.91± 2.70 years in Group A , 137 patients aged from 71 to 80 year old in Group B, and 91 patients aged from 60 to 70 year old in Group C. Results Preoperative ASA grade in Group A was higher than that of the other two groups （P≤0.05）, but no obvious difference in operating time （ 40.03± 18.90）min （P 〉0.05）. Follow-up was obtained in 44 （80.00%） patients; of them 10 patients were deaths with a survival time of 22.90 ± 11.14 months. For 34 survivors in groupA, barthel index score was 66.03±17.46, and for 18 of them （52.94%）, score was 〉60; Score of 10 （29.41%） patients was 41-60 and 6 （17.65%） patients was 〈40. IPSS score of 34 patients in group A was 11.35±7.04, there was a significant difference in IPSS score compared with that of Group C （P〈0.01）. QOL index was 1.23±0.76, there was a significant differnece compared with that of the other two groups （P〈0.05）. Conclusion TUVRP surgical risk in patients over 85 years old is higher than that in patients below 80 years old. But most patients over 85 years old had satisfactory voiding function and better activities in daily living after TUVRP. A safety TUVRP could improve their activities of daily living and quality of life.

关 键 词：经尿道前列腺切除术 老年人 85岁以上 生活质量 

分 类 号：R697.32[医药卫生—泌尿科学]