选择性激光前列腺汽化术治疗大体积前列腺增生82例的疗效及安全性观察

Clinical Observation on Therapeutic Effect and Safety of Photoselective Vaporization of Prostate in Treatment of Large Prostate (Report of 82 Cases)

目的探讨选择性激光前列腺汽化术(PVP)治疗大体积前列腺增生(前列腺体积>100ml)患者的临床效果及安全性。方法回顾性分析82例体积>100ml的前列腺增生患者PVP治疗结果。结果所有患者前列腺平均体积176(110～340)ml,77例手术1次完成,5例手术分两次进行。所有患者术后排尿困难症状明显改善,国际前列腺症状评分(IPSS)由术前平均27.5分降至8.4分,生活质量(QOL)评分由4.6分降至2.1分,最大尿流率(Qmax)由4.9ml/s上升至19.0ml/s,残余尿量(RUV)由350ml降至110ml,均有统计学意义(P<0.01)。结论PVP是治疗体积>100ml前列腺增生患者的一种安全、有效的手术方法。

Objective To study the safety and effectiveness of photoselective vaporization of prostate （PVP） in treatment of large prostate with volume more than 100 ml. Methods Retrospective analysis was performed in 82 benign prostatic hypertrophy （BPH） patients undergoing the PVP treatment,whose prostate volmue was more than 100ml. Results Average prostatic volume in all cases was 176 （110340）ml. The operation in 77 cases was successfully completed in one time. But in other 5 cases,the twice operation was performed. In all cases,the dysuria symptom improved noticeably. International prostate symptom score （IPSS） and quality of life score （QOL） decreased from preoperative 27.5and 4.6 to postoperative 8.4 and 2.1,respectively. Maximal urinary flow rate （Qmax） increased from 4.9ml/ s to 19.0ml/s,and residual urine volume （RUV） decreased from 350ml to 110ml. IPSS,QOL,Qmax and RUV were significantly improved,compared with preoperative data（P〈0.01）. Conclusion PVP is believed to be a safe and efficacious surgical method in treatment of large prostate with volume more than 100ml.