选择性绿激光前列腺汽化术治疗高龄良性前列腺增生症90例报告

Greenlight Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia in Aged Patients: A Report of 90 Cases

目的评价选择性绿激光前列腺汽化术（greenlight photoselective vaporization of the prostate,PVP）治疗高龄良性前列腺增生症（benign prostatic hyperplasia,BPH）的疗效。方法2004年10月-2005年9月,采用连续硬膜外麻醉或骶管麻醉,应用Laserscope公司绿激光系统,以80 W功率对90例高龄BPH进行选择性光汽化术,术后留置尿管,持续膀胱冲洗4-5 h。结果手术时间（42.5±18.4）min,术后留置尿管时间（2.5±0.8）d。最大尿流率由术前（4.8±1.2）ml/s开至术后（18.6±1.4）ml/s（t=22.566,P=0.000）;IPSS评分由术前（25.5±2.4）分降至术后（13.2±1.9）分（t=12.286,P=0.000）;膀胱残余尿量由术前（76.3±9.4）ml降至术后（16.5±2.4）ml（t=21.901,P=0.000）。术后出现4例短暂性排尿困难,2例迟发性出血,无尿失禁等其他并发症发生。结论PVP治疗BPH安全有效,并发症少,较适合于高龄、高危BPH患者。

Objective To evaluate the efficacy of greenlight photoselective vaporization of the prostate （PVP） for benign prostatic hyperplasia（BPH） in aged patients. Methods A total of 90 aged patients with BPH underwent PVP with an 80 W KTP laser（ Laserscope Company） under sacral or peridural anesthesia. Results The operative time was （42. 5 ± 18. 4） min; the postoperative urinary catheter time was（2.5 ±0. 8） d. Qmax increased significantly from（4.8 ± 1.2） ml/s preoperatively to （ 18.6 ± 1.4） ml/s postoperatively （ t = 22. 566, P = 0. 000）. International prostate symptom score decreased from （ 25. 5 ± 2. 4 ） points preoperatively to （ 13.2 ± 1.9 ） points postoperatively （ t = 12. 286, P = 0. 000 ）. Residual urine decreased from （ 76. 3 ± 9.4 ） ml preoperatively to（ 16.5 -± 2.4） ml postoperatively （ t = 21. 901 , P =0. 000）. Transient dysuria occurred in 4 cases and postoperative delayed hemorrhage in 2 cases. No urinary incontinence occurred. Conclusions PVP for BPH is a safe and effective procedure, and suitable for aged and high-risk patients with BPH.