绿激光前列腺汽化术治疗BPH60例报告

Greenlight vaporization of prostate for the treatment of benign prostatic hyperplasia(Report of 60 cases)

目的：探讨经尿道绿激光前列腺汽化术治疗BPH的手术方法和近期疗效。方法：采用骶管或硬膜外腔阻滞麻醉，应用美国Laserscope公司生产的非接触式绿激光治疗系统，以80W功率对60例BPH患者进行汽化治疗。结果：本组汽化时间10～250min，平均（104．21±81．31）min；耗能21．24～531．11kJ，平均（230．02±150．34）kJ；术后10例末留置导尿管，余50例留置导尿管24～120h，平均（64．70±25．52）h；膀胱冲洗24～96h，平均（58．44±20．24）h；术后住院3～9天，平均（4．57士1．83）天。术前平均最大尿流率（Qmax）（7．5土3．12）ml／s，术后平均Qmax（16．78±4．56）ml／s；术前剩余尿量0～800ml，平均（111．00±177．85）ml；术后剩余尿量0～30m1，平均（12．73±5．91）ml；术前平均IPSS和QOL分别为（26．50±3．18）分和（4．60±0．28）分，术后下降至（6．24±1．86）分和（1．83±0．52）分，与术前比较差异有统计学意义（P〈0．05）。术前留置导尿管16例，术中均未输血，术后尿频12例，继发出血2例，术后24天突发尿潴留1例。结论：绿激光前列腺汽化术治疗BPH安全、操作简单、手术时间短、出血少、痛苦小、留置导尿管时间短、康复快，是一种理想的微创手术方法。

Objective：To evaluate the surgical technique and efficacy of greenlight vaporization of prostate for the treatment of benign prostatic hyperplasia（BPH）. Methods; A total of 60 patients with BPH were treated with Niagara PVTM system under sacral anesthesia or epidural anesthesia. Results：The mean operation duration was 104. 21±81.31 rain （range 10-250 rain） and the mean cost energy was 230.02±150.34 kJ（range 21. 24 - 531.11 kJ）. No postoperative catheterization needed in 10 patients. The mean catheterization time was 64.70± 25.52 h （range 24-120 h）. The mean postoperative irrigation time was 58.44±20.24 h（range 24- 96 h） . The mean postoperative hospital stay time was 4. 574-1.83 d （range 3-9 d）. The mean Qmax value increased from 7.5± 3.12 ml/s to 16.78±4.56 ml/s. The mean postvoid urine residual volume （PURV） decreased from 111.00± 177.85 ml to 12.73±5.91 ml. The mean IPSS and QOL decreased from 26.50±3.18 and 4.60±0.28 to 6.24±1.86 and 1.83±0.52,respectively, which showed significant improvement（ P 〈0.05）. There were 16 cases catheterizated before operation. No patients required blood transfusion. Postoperatively 12 cases had frequency, 2 experienced delayed hematuria and 1 acute urinary retention after 24 days. Conclusions：The greenlight vaporization of prostate is minimal invasion for the treatment of BPH. It can yield rapid,safe and effective relief for patients with obstructive BPH. It is characterized by shorter operative duration,few blood loss and shorter catheterization.