经尿道选择性绿激光PVP治疗高龄高危良性BPH

Evaluation of green light PVP on treating high-risk old patients with benign prostatic hyperplasia

目的探讨经尿道选择性绿激光前列腺汽化术(photoselective vaporization of prostate,PVP)治疗高龄高危良性前列腺增生(benign prostatic hyperplasia,BPH)的治疗效果。方法采用PVP治疗高龄高危BPH患者89例,术前评估准备、观察平均手术时间、术后拔管时间,出血量,术前、后国际前列腺症状评分(international prostate symptomscore,IPSS)、生活质量评分(quality of life,QOL)、剩余尿量及尿流率变化等指标。结果89例患者手术成功。手术时间平均(44.8±35.0)min。术中出血量平均(64.1±16.3)ml。术后留置导尿管平均(3.6±2.7)d。IPSS及QOI评分由术前平均(27.8±6.5)及(6.3±0.9)分别下降至(7.14±2.6)及(1.4±0.8),最大尿流率术前(6.2±2.8)ml/s增加至术后(14.7±2.2)ml/s,剩余尿量由术前(186.1±25.2)ml下降至术后(26.6±5.1)ml,手术前后比较差异均有统计学意义(P<0.05)。手术安全,疗效满意,无严重并发症。结论PVP针对治疗高龄高危BPH是安全有效的微创手术。

Objective To explore the efficacy and safety of green light photoselective vaporization of prostate （PVP） on high-risk older patients with benign prostatic hyperplasia（BPH）. Methods Eighty-nine highrisk older patients with BPH were underwent PVP. The operative time,blood loss, indwelling catheterization and operative complications were observed. The variables such as international prostate symptom score （IPSS） ,quality of life （QOL）,uroflowmetry, post-void residual urine volume（RUV） were recorded and calculated pre-and post-operatively. Results All the 89 patients safely got through perioperative period. The mean operation time was（44.8±35.0 ）min, intraoperative blood loss was （64. 1±16.3 ）ml and postoperative indwelling catheterization was（3.6±2.7 ）d. IPSS and QOL scores decreased form （27.8± 6.5 ） and （6.3±0.9） preoperatively to （7.14± 2.6 ） and （ 1.4± 0.8 ） postoperatively respectively. Max-uroflowmetry increased from （ 6.2± 2.8 ） ml/s to （ 14.7±2.2 ） ml/s and RUV decreased from （ 186.0 ±25.2 ） ml to （ 26.6±5.1 ） ml. These parameters had significant differences before and after operation （ P 〈 0.05 ）. There were few complications and great satisfactions with the short-term post-operative results. Conclusion PVP is a safe, efficacious and minimally invasive procedure for older patients with high-risk BPH .