选择性绿激光前列腺汽化术治疗高危前列腺增生62例

Photoselective green - light laser vaporization of prostate in the treatment of high risk benign prostatic hyperplasia in 62 cases

目的探讨绿激光治疗老年重度前列腺增生的疗效和安全性。方法应用绿激光PVP治疗老年前列腺增生62例。观察手术前后国际前列腺症状评分（IPSS）、生活质量评分（QOL）、尿流率、剩余尿量的变化，记录术中出血量、手术时间、术后留置尿管时间、手术并发症情况。结果本组62例，手术时间40～130min，平均55min。术中出血30～140ml，平均50ml，术中均未输血；术后留置尿管0～3d，平均2d。术后均排尿通畅，伴轻度尿道刺激症状9例，延迟出血1例，无尿失禁等严重并发症。术后3～6个月最大尿流率由术前平均5．8ml／s增加到术后平均16．2ml／s，IPSS评分和QOL评分术后均有明显改善（P〈0．05）。结论绿激光PVP治疗高危重度前列腺增生手术安全性高、操作简单、出血少、手术时间短、尿管留置时间短、恢复快，治疗效果满意。

Objective To study the safety and efficacy of photoselective green - light laser vaporization of prostate（PVP）for the treatment of high risk benign prostatic hyperplasia （BPH）. Methods A total of 62 patients with symptomatic bladder outlet obstruction due to high risk BPH underwent PVP under sacral anesthesia. The therapeutic results were assessed using the following variables：blood loss during operation,operative time,indwelling catheterization,Qmax,IPSS,QOL. Results The mean operative time was 55 rain（range,40 - 130 min）. No patient required blood transfusion. The mean catheterization time was 24 h（range ,0 -72 h）. The mean Qmax increased from 5.8 ml/s operatively to 16.2 ml/s postoperatively ,and IPSS and QOL showed significant improvement postoperatively（ P 〈0.05）. Conclusion PVP with green -light laser is a good therapy with good efficacy and high security for BPH in high risk ,which is simple ,rapid ,less bleeding and has short catheterization time.