经尿道光选择性绿激光汽化术治疗前列腺增生的临床研究

Photoselective vaporization of prostate for the treatment of benin prostatic hyperplasia

目的：观察经尿道光选择性绿激光汽化术治疗前列腺增生的临床疗效。方法：采用硬膜外麻醉，应用PVP技术治疗BPH患者112例。观察术中山血、手术时间、术后留置尿管时间、手术前后尿流率、国际前列腺症状评分（IPSS）、生活质量评分（QOL）、及性功能等变化情况。结果：112例患者中有97例采用硬膜外麻醉，14例骶麻，1例阴部神经阻滞麻醉。术中110例手术顺利，1例前列腺尿道部损伤山血，1例膀胱穿孔。手术时间14～160min，平均（45．8±16．4min）。术中无输血病例。术后28例未留置尿管；有69例术后保留尿管16±28h；有9例留置尿管3．5d；6例留置尿管5d以上。98例术后随访2～24个月，最大尿流率由术前平均（6．6±3．4）ml／s增加至术后（17．6±2．8）mL／s，IPSS和QOL与术前对比均有明显改善。术前有性功能的68例患者术后无勃起功能障碍发生。结论：PVP技术治疗BPH具有操作简单、出血少、留置尿管时间短、术后并发症少、疗效好等优点。

Objective： To evaluate the efficacy of photoselective vaporization of prostate （PVP） for the treatment of benign prostatic hyperplasia （BPH）. Methods： A total of 112 patients with symptomatic bladder outlet obsraction due to PBH underwent PVP via transurethral with Niagara PVTM system. The therapeutic results were assessed using following variables： loss blood during operation, operative.time, inwelling catheterization, mean Qmax, IPSS, QOL and the sexual function. Results： The PVP was Successfully performed on all the 112 patients with BPH. There were 96patients under epidural anesthesia, 14 under sacral anesthesia and 1 under pudendal nerve block anesthesia. The mean operative time was （45.8±16.4）min （range, 14-160 min）. All patients had minimal or no blood loss and no patients requireci blood trasfusion. No postoperative catheterazition was needed in 28 patients. The catheterization time was 16-24h in 69 patients, 2-5 days in 9 and 〉 5 days in 6. 98 patients were followed up for 2-12 months after operation. IPSS and QOL were showed significant improvement respectively, compared with those before operation. The 68 cases with sexual function still remained potent postoperatively. Conclusions： The PVP was believed to be a safe and excellent tretment preeedure for BPH.