微创绿激光PVP治疗高危BPH

Treatment of BPH in high risk patients with minimally invasive green laser photoselective vaporization of prostate

目的：探讨经尿道选择性绿激光前列腺汽化术（PVP）治疗高危老年BPH的安全性和疗效。方法：采用骶管麻醉，应用PVP手术治疗高危BPH患者56例，对手术出血、手术时间、术后留管时间、尿流率、IPSS、QOL进行观察。结果：手术时间20～180min，平均（52．0±22．1）min，术中无输血。留置尿管时间6～72h，平均（46±21．3）h，拔除尿管后均能自行排尿，无继发性出血、尿失禁等并发症。术后3～6个月，最大尿流率由术前平均（4．3±2．1）ml／s增加至术后平均（15．4±2．3）ml／s，IPSS及QOL术后均有明显改善（P〈0．05）。结论：选择性绿激光前列腺汽化术治疗高危老年BPH，操作简单，手术时间短，出血少，尿管留置时间短，疗效好，安全性高。

Objective,To study the safety and efficacy of transurethral photoselective vaporization of prostate （PVP） for the treatment of high risk benign prostatic hyperplasia（BPH）. Methods.. A total of 56 patients with symptomatic bladder outlet obstruction due to high risk BPH underwent PVP under sacral anesthesia. The thera- peutic results were assessed using following variables： blood loss during operation, operative time, indwelling catheterization, Qmax, IPSS, QOL. Results.. The mean operative time was （52. 0 ± 22. 1） min（range, 20- 180 min）. No patients required blood transfusion. The mean catheterization time was 46±21.3h（range,6-72 h）. The mean Qmax increased from（4.3 ± 2. 1 ）ml/s operatively to（ 15.4 ± 2.3）ml/s postoperatively, and IPSS and QOL showed significant improvement postoperatively（ P 〈0.05）. Conclusions：PVP with green laser is a good treatment with good efficacy and high security for BPH in high risk, which is simple, rapid, less bleeding and has short catheterization time.