高能选择性绿激光汽化术治疗良性前列腺增生(附200例报告)

Photoselective vaporization of prostate for the treatment of benign prostatic hyperplasia

目的：探讨经尿道高能选择性绿激光前列腺汽化术（PVP）治疗良性前列腺增生（BPH）的有效性和安全性。方法：采用连续硬膜外麻醉、骶管麻醉或全麻，应用PVP治疗BPH患者200例，观察术中组织汽化效果、出血情况、手术时间、术后尿管留置时间、手术前后尿流率、国际前列腺症状评分（IPSS）、生活质量评分（QOL）等变化情况。结果：PVP汽化效果良好，手术时间15～120min，平均55min，术中基本无出血。术后195例留置尿管时间1～5天，平均3天，其中拔出尿管后4例出现短暂排尿困难，无尿失禁等并发症发生；5例未留置尿管。术后随访3～6个月，最大尿流率、IPSS及QOL较术前均有明显改善。结论：PVP治疗BPH安全有效，操作简单，时间短，出血少，尤其适合于高龄、高危患者。

Objective：To evaluate the safety and efficacy of photoselective vaporization of prostate（PVP） for the treatment of benign prostatic hyperplasia（BPH）. Methods： A total of 200 patients with symptomatic bladder outlet obstruction due to BPH underwent PVP via transurethral with Niagara PVTM system. The therapeutic resuits were assessed using following variables： the safety and efficacy of tissue vaporization, blood loss, operative time, indwelling catheterization, mean Qmax, IPSS, QOL. Results： The effect of The PVP was excellent. The mean operative time was 55 min（range, 15-120 min）. All patients had minimal or no blood loss. No postoperative catheterization was needed in 5 patients. The mean time of indwelling catheter was 72h （range, 24-120 h）. Postoperatively 4 cases had transient dysuria. All cases were followed up for 3 to 6 months after treatment. The mean Qmax,mean IPSS and QOL,which showed significant improvement. Concinsions：The PVP is an excellent treatment modality for BPH. It can yield rapid,safe and effective relief for patients with obstructive BPH,especially for those at advanced age or at high risk.