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目的探讨柱状水囊经尿道扩开术治疗高危高龄良性前列腺增生(BPH)的安全性和临床疗效。方法选择BPH患者113例,年龄68-94岁。根据患者前列腺体积大小和膀胱残余尿量(PVR)的多少,选择不同型号的柱状水囊导管。在低位腰、硬联合麻醉下,将导管经尿道定位在后尿道,分别向内外囊内注水至0.3MPa,然后关闭内外囊注水管。术后根据患者的具体情况放水减压和镇痛。结果从置管定位到注水扩开平均手术时间为10min;术后导管留置3-5d。扩开术后3-24个月复查,最大尿流率(Qmax)平均增至(15.8±2.1)ml/s,PVR降至(22.0±8.1)ml,国际前列腺症状评分(IPSS)降至(6.8±1.2)分,生活质量评分(QOL)降至(1.4±0.3)分,均较术前明显改善。结论对高危高龄患者,术前控制内科疾病,采取柱状水囊经尿道扩开,是前列腺诸多手术中唯一保留原脏器的手术,创伤极微,手术时间短,安全系数高。
Objective To investigate the safety and clinical efficacy of cylindrical hydrocele transurethral expansion in the treatment of high-risk benign prostatic hyperplasia (BPH). Methods 113 BPH patients were selected, aged 68-94 years. Depending on the size of the patient’s prostate and residual bladder volume (PVR), different types of cylindrical balloon catheters were chosen. In the low waist, hard joint anesthesia, catheterization of the urethra in the posterior urethra, respectively, inside and outside the capsule into the water to 0.3MPa, and then close the inside and outside the capsule injection tube. After surgery according to the specific circumstances of patients with water decompression and analgesia. Results From the catheter positioning to water injection to open the average operation time was 10min; postoperative catheters indwelling 3-5d. The maximal flow rate (Qmax) increased to (15.8 ± 2.1) ml / s and the PVR decreased to (22.0 ± 8.1) ml, and the International Prostate Symptom Score (IPSS) decreased to ( 6.8 ± 1.2), and the QOL decreased to (1.4 ± 0.3) points, both of which were significantly improved compared with those before operation. Conclusion For high-risk patients, preoperative control of medical diseases and the expansion of the columnar water sac through the urethra are the only procedures that retain the original organ in many prostate surgeries. The trauma is minimal, the operation time is short, and the safety factor is high.