良性前列腺增生癥(文件)
【正文】 ed on the Medical Therapy of Prostatic Symptoms and Combination of Avodart and Tamsulosin Trials.,The 2022 EAU guidelines recommend 5ARIs for LUTS with benign prostatic obstruction . They recommended that 5ARIs should be offered to men who have moderate to severe LUTS，prostate size≥40g，and a PSA level＞1.4–1.6g/L，and they indicated that 5ARIs can prevent progression and the need for prostate surgery .,The NICE in the UK developed the NICE guidelines for highquality healthcare and encouraged healthy living based on the evidence. The NICE guidelines for LUTS，which are shown in a detail in，recommend 5ARIs for men with LUTS who have a prostate size≥30g，PSA≥1.4ng/mL，and a risk for progression. Combination therapy with an alpha blocker can be considered for patients with bothersome moderate to severe LUTS，prostate size≥30g，and PSA≥1.4ng/mL.,各國臨床指南(zhǐn225。 有嚴(yán)重心、肺、肝、腎功能不全者，先通過留置導(dǎo)尿管或恥骨上膀胱造瘺術(shù)引流尿液，待情況好轉(zhuǎn)后再行手術(shù)。)方案選擇,可用于一般情況較差，不能耐受手術(shù)或不愿接受(jiēsh242。o)的首選方法。,手術(shù)(shǒush249。b236。uguǎn)，定期更換，維持引流尿液通暢。o)目的是評估療效、確定治療的依從性、盡早發(fā)現(xiàn)與治療相關(guān)的副作用或并發(fā)癥，并提出解決方案，同時(shí)監(jiān)測前列腺癌的發(fā)生。o ti225。i ni224。,臨床診斷：主要以典型病史、體征、B超等為主，思維培養(yǎng)和形成是重點(diǎn)。,Thanks for your attention !,第三十七頁，共三十八頁。,。ir243。,第三十五頁，共三十八頁。,體征：直腸指診非常(fēich225。n)：老齡和有功能的睪丸。,總 結(jié),發(fā)病的必要條件(b236。,BPH各種治療后都應(yīng)進(jìn)行隨訪。,第三十二頁，共三十八頁。b236。,2 開放手術(shù)(shǒush249。,1 經(jīng)尿道前列腺切除術(shù)〔TURP〕 具有效果好，創(chuàng)傷小，患者恢復(fù)快等特點(diǎn)，是前列腺增生手術(shù)治療(zh236。,一般手術(shù)(shǒush249。,三 手術(shù)治療 手術(shù)指證： 1 重度BPH的下尿路病癥已明顯影響患者生活質(zhì)量； 2 當(dāng)BPH導(dǎo)致以下并發(fā)癥時(shí)：反復(fù)尿潴留；反復(fù)血尿；反復(fù)泌尿系感染；膀胱結(jié)石；繼發(fā)性上尿路積水〔伴或不伴腎功能損害〕。)尿道,膀胱頸前列腺平滑肌的肌肉緊張,通過激素機(jī)制縮小前列腺體積，改善病癥、增加尿流
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