RevoLix 2μm激光治疗高龄高危良性前列腺增生症（附36例报告）

RevoLix 2 micron continuous wave laser vaporesection for treat- ment of elderly and high risk benign prostatic hyperplasia, report of 36 cases

目的探讨高龄高危前列腺增生症患者采用RevoLix2μm激光汽化切割术的疗效。方法本组36例，年龄70～82岁。均伴有内科疾病，于内科疾病治疗稳定后手术。手术应用RevoLix2μm激光系统，激光输出功率70w，冲洗液为0．9％氯化钠溶液。术中确定精阜位置及到膀胱颈距离后进行激光汽化切割。结果手术时间65～135min，平均时间（83．6±10．6）min。术中术后无大量出血，无输血事件及电切综合症发生。术后拔除尿管时间为术后2～4d，拔出导尿管后均能自行排尿，2例患者发生一过性尿失禁，其余患者无尿失禁。3～6个月随访IPSS评分由（24．26±2．70）分下降为（8．47±4．32）分；QOL评分由（4．51±0．56）分下降为（1．34±0．53）分；最大尿流率由（6．37±1．31）mL／s上升为（17．24±2．32）mL／s。结论RevoLix2μm激光汽化切割术对高龄高危前列腺增生患者来说，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 RevoLix 2 micron continuous wave laser vaporesection for treatment of elderly and high risk benign prostatic byperplasia patients. Methods Clinical data of 36 benign prostatic hyperplasia patients with medical complications aging 70 -82 years were retrospectively analyzed. Operations were done after their complications were controlled. The RevoLix 2 μm laser system with output power of 70 W was used, and normal saline was used as rinse solution. Operations were started after positions of semin^d colliculus and distances to neck of bladder were confirmed. Results Operation time varied from 65 to 135 min with a mean time of （83.6±10. 6） min. Occasional venous hemor- rhage occurred during operation but no arterial hemorrhage was observed. No blood transfusion necessitated and no TURP syndrome was observed. Catheter was removed 2-4 days after operation. All the patients could urinate freely. No urinary incontinence was found during follow-up except 2 patients with temporary urinary incontinence. A 3-6 months follow-up showed that IPSS decreased from 24. 26±2. 70 to 8.47±4. 32, QOL dropped from 4. 51±0. 56 to 1.34±0. 53, and Qmax increased from （6. 37± 1.31 ） mL/s to （ 17.24 ± 2. 32） mL/s. Conclusions RevoLix 2 micron continuous wave laser vaporesection is a safe and effective method with less trauma and fast recovery for treating elderly and high risk benign prostatic hyperplasia patients.