选择性绿激光汽化术治疗良性前列腺增生症的疗效和并发症

Therapeutic effect and complication of greenlight photoselective vaporization of prostate in the treatment of benign prostatic hyperplasia

目的:探讨选择性绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)的疗效和并发症。方法:应用PVP治疗BPH患者204例。结果:术后最大尿流率增加,IPSS评分、QOL评分、残余尿量均较术前下降,差异均有统计学意义(P<0.05)。术后出现的并发症有膀胱痉挛、尿路刺激症状、排尿困难、继发性出血、尿失禁、发热等,经治疗好转。结论:此方法操作简单、出血少、痛苦较小,适于高龄、高危患者。但仍有一定并发症,要妥善处理。

Objective： To investigate the therapeutic effect and complications of greenlight photoselective vaporization of prostate （PVP） in the treatment of benign prostatic hyperplasia （BPH）. Methods- A total of 204 patients with BPH underwent PVP. The operation time, blood loss, indwelling catheterization and complications were observed. The variables such as IPSS, QOL, uroflowmetry, and residual urine volume （RUV） were recorded and calculated before and after operation. Results： All patients safely got through perioperative period. The mean operation time was （ 85.0 ± 22.4 ） minutes ; The postoperative indwelling catheterization was （ 90.4 ± 15.8 ） hours. IPSS and QOL scores decreased from preoperative （24.8 ± 3.2） and （6.5 ± 0.5 ） to postoperative （6.8 ±1.4） and （1.9±0.6）, respectively. Qmax increased from （7.5±3.4） ml/s to （20. 8±3.1） ml/s, and RUV decreased from （ 168. 0±22. 5） ml to （24. 6±6. 81 ） ml. There were significant differences before and after Operation （ P〈0. 05 ）. There happened some complications including gentle urethra stimulating symptom （99 cases） , bladder spasm during indwelling catheterization （45cases） , gentle transient dysuria （21 cases） , delayed hematuria （54） , urinary incontinence （ 55 ） and postoperative febrile （ 60 ）. Conclusions： PVP is an excellent treatment modality for BPH. It safe and effectively relieve the obstructive BPH with minimal invasion, better tolerance and rapid recovery, especially fit for the aged and high - risk patients. However, it causes certain complications that need to be treated carefully.