Objective To discuss the efficacy and safety of transuretheral plasmakinetic resection of prostate(PKRP)in benign prostatic hyperplasia(BPH)patients complicated with Alzheimer's disease(AD). Methods From January 2009 to December 2015,there were 33 BPH patients complicated with AD of totally 257 patients who had received the operations of PKRP. The average age was 71.3(60-87)years. Pre-operative main symptoms were different:5 cases with urinary frequency and urgency,16 cases with urination wait,9 cases with repeated urinary retention,and 3 cases with overflow incontinence. Pre-operative urodynamic studies were suggestive of bladder outlet obstruction. Results The operation time was 35~130min,average(45.3±35.5)min,and the weight of cutoff prostate tissues was 25~90g,average(38.6±27.8)g. 2 cases had the events of peri-operative blood transfusion,and no transurethral resection syndrome or obturator nerve reflex occurred. The post-operative delirium were observed in 23 cases and well controlled after medication. The follow-up time was 6~12 months. The main symptoms were significantly improved postoperatively compared with pre-operation,but dysuria and urinary retention were presented in 2 cases and mild incontinence in 1 case. Maximum urinary flow rate (Qmax),the International Prostate Symptom Score(IPSS)and Quality of Life(QoL)after surgery obtained a better improvement than before. Conclusion PKRP is an effective and safe surgery for the treatment of BPH patients complicated with Alzheimer's disease.%目的 探讨合并阿尔茨海默病(AD)的前列腺增生(BPH)症患者行经尿道等离子电切术(PKRP)治疗BPH的有效性和安全性.方法 自2009年1月至2015年12月接受PKRP病例共257例,其中行PKRP的BPH合并AD患者33例.该类患者年龄60~87岁,平均71.3岁.术前主要症状表现为尿频、尿急5例,排尿等待16例,反复尿潴留9例,充溢性尿失禁3例.术前行尿动力学检查皆提示有膀胱出口梗阻.结果 手术时间35~130min,平均(45.3±35.5)min,切除前列腺组织重量25~90g,平均(38.6±27.8)g.2例患者围手术期输血,无1例发生尿道电切综合征和闭孔神经反射.PKRP术后23例术后出现谵妄症状,经药物控制后好转.患者术后随访6~12个月.30例排尿顺畅,症状较术前有明显改善;2例患者术后仍有排尿困难、尿潴留,1例患者存在轻度尿失禁表现,使用药物调整治疗后好转.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)均比术前明显好转.结论 AD合并BPH症患者行PKRP是有效、安全的治疗方法.
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