绿激光汽化术治疗高龄高危前列腺增生症47例

Treatment with photoselective vaporization of the prostate for 47 elderly and high risk BPH patients

目的探讨高龄高危前列腺增生症前列腺选择性光汽化术(PVP)的疗效。方法本组47例,年龄78～92岁。经肛诊及B超确诊。均伴有内科疾病,于内科疾病治疗稳定后手术。手术应用美国GreenLight PV激光系统(绿激光系统),激光输出功率80W,冲洗液为生理盐水。激光光纤通过23Fr连续冲洗膀胱镜导入,确定精阜位置及到膀胱颈距离后进行激光汽化,至见到环形肌纤维为止。结果手术时间27～65min,平均时间37min。术中术后无大量出血,无死亡病例。术后尿管无需牵引,拔除尿管时间为13～45h,拔出导尿管后均能自行排尿,无尿失禁。术后残尿平均0～16ml。结论前列腺选择性光汽化术(PVP)术中、术后出血量少,手术时间大大缩短,术后早期即可离床轻微活动,留置尿管和住院时间明显缩短,腺体组织汽化彻底,手术操作简单。PVP对高危BPH患者来说,是一种安全有效、创伤小、恢复快的治疗方法。

Objective To investigate the curative effect of photoselective vaporization of the prostate （PVP） for elderly and high risk BPH patients. Methods Clinical data of 47 BPH patients with medical complications aging from 78-92 years were retrospectively analyzed. They were diagnosed by DRE and B ultrasound. Operations were taken after their complications were controlled. We used American GreenLight PV laser system with output power of 80 watt was used, normal saline was used as rinse solution. Laser optic fibers were lay in through 23Fr cistoscope with continuous rinsing system. Operations were started after positions Of seminal colliculus and distances to neck of bladder were confirmed. The depth of Prostate vaporization reached circular fibers. Results Operation time varied from 27-65min with a mean time of 37min. Occasional venous hemorrhage occurred during operation but no arterial hemorrhage was observed. No dead was happened. Catheter was removed varied between 13-45h after operation. All the patients could urinate freely. No urinary incontinence was found during follow-up. Postoperative PVR varied from 0-16ml. Conclusion PVP is a safe and effective method with less trauma and fast recovery for treating high risk BPH patients.