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目的探讨经尿道等离子体双极电切治疗高龄良性前列腺增生的安全性与有效性。方法采用英国Gyrus等离子双极切割系统(gyrus-plasma kinetic system,PKS)行经尿道前列腺切除术150例。结果150例手术顺利,手术操作时间平均47min,平均切除前列腺63g,无输血病例,术中无闭孔神经反射及电切综合征(TURS)出现。术后IPSS由(28.5±4.8)分降至(10.5±3.2)分;最大尿流率(Qmax)由(5.8±2.2)mL/s上升至(23.8±3.3)mL/s;生活质量评分(QOL)由术前的(6.5±1.2)下降至(1.0±0.8);剩余尿(RU)由(120.3±40.3)mL降至(15.6±8.3)mL,4项指标手术前后比较差异均有显著性(P<0.05)。结论经尿道前列腺等离子双极汽化电切术是一种安全有效的微创术式,尤其适合于高龄高危重度前列腺增生患者。
Objective To investigate the safety and efficacy of transurethral plasma bipolar electrotomy for the treatment of elderly patients with benign prostatic hyperplasia. Methods A total of 150 cases underwent transurethral resection of the prostate with Gyrus-plasma kinetic system (PKS). Results The operation of 150 cases was successful and the operation time was averagely 47 minutes. There was an average of 63 g of prostate resection, no blood transfusion cases, no obturator nerve reflex and TURS during operation. The postoperative IPSS decreased from (28.5 ± 4.8) points to (10.5 ± 3.2) points, and the maximum flow rate (Qmax) increased from 5.8 ± 2.2 mL / s to 23.8 ± 3.3 mL / s. The quality of life score QOL) decreased from (6.5 ± 1.2) to (1.0 ± 0.8) preoperatively, while the residual urine (RU) decreased from (120.3 ± 40.3) mL to (15.6 ± 8.3) mL. There were significant differences in the four indexes before and after operation (P <0.05). Conclusions Transurethral plasmapaptation of prostate is a safe and effective method for minimally invasive surgery. It is especially suitable for elderly patients with high-risk severe benign prostatic hyperplasia.