摘要
目的：探讨痴呆综合征（Dementia syndrome,DS）患者经尿道等离子电切治疗前列腺增生的有效性和安全性。方法：自2000年2月-2005年6月,在我院接受开放性前列腺切除术、经尿道前列腺电切术（TURP）及经尿道等离子电切前列腺病例共316例,对其中12例行PKRP的DS合并BPH患者进行临床研究。患者年龄71-85岁,平均73.4岁。其中表现为尿失禁1例,尿频2例,尿等待5例,尿潴留（AUR）4例。既往脑血管意外病史6例,高血压极高危组5例,2型糖尿病4例,心绞痛1例,帕金森病1例,肝炎1例。术前各项检查均显示适合行PKRP手术。结果：PKRP手术时间30-200min,平均（50.1±39.5）min,切除前列腺组织重量20-100g,平均（35.5±30.3）g。3例患者围手术期输血400ml,其余患者均未行输血。PKRP术后无1例发生经尿道电切综合征（TURS）,4个月内无死亡患者。患者术后随访1-4个月。8例患者排尿良好,2例患者术后排尿有明显改善,但需间断导尿,2例患者存在轻微的尿失禁现象。最大尿流率（Qmax）、国际前列腺症状评分（IPSS）以及生活质量评分（QOL）等3项指标比较手术前明显好转。结论：DS患者行PKRP和精心护理是有效、安全的治疗方法。
Objective To evaluate the efficacy and safety of transurethral resection of hyperplastic prostate with plasmakinetic energy （PICRP） for patients with dementia syndrome （DS）. Method During the period of February 2000 to June 2005 ,prapubic transvesical prostatectomy, TURF and PKRP were performed on 316 patients with benign prostatic hyperplasia （BPH）. Among them, 12 of dementia between 71 and 85 years old. One presented with urinary incontinence,2 with frequent micturition,5 with urinary hesitancy and 4 with urine retention. Past history included cerebrovascular accident in 6 ,hypertension in 5 ,diabetes in 4 ,angina pectoris in 1 ,Parkinson＇s disease in 1 and hepatitis in 1. Careful preoperative examinations （confirmed by IPSS, urinary flow rate, ultrasonographic estimate and PSA test） revealed that they were proper candidates for PKRP. Results For PKRP,the duration of the procedure was （50. 1±39. 5）min （30 -200min）. The adenoma resected weighed （35.5±30. 3）g on the average,ranged from 20 to 100g. Three patients needed blood transfusion （400ml） ,the other patients needed no blood transfusion during the operation,and no transurethral resection syndrome occurred or died within 4 months after PKRP. All patients follow -up period lasted 1.0 - 4. 0 months. Eight patients reported good urination,2 reported some improvement in urination after surgery, although requiring intermittent catheterization and 2 developed mild urinary incontinence. Conclusion It is suggested that transurethral biolar plasmakinetic resection of prostate and carefully nursing for patients with dementia is effective and safe.
出处
《吉林医学》
CAS
2009年第12期1068-1071,共4页
Jilin Medical Journal
