2μm激光汽化切除术治疗高龄高危良性前列腺增生

Two micron continuous wave laser vaporesection for the treatment of high-risk senior patients with benign prostatic hyperplasia

目的探讨2μm激光汽化切除术治疗高龄高危良性前列腺增生（BPH）的安全性和有效性。方法应用70W 2μm连续波医用激光对65例高龄高危BPH患者行2μm激光前列腺汽化切除术。患者年龄80~92岁,平均（84.6±2.7）岁。观察平均手术时间、术中出血量、术后留置尿管时间、手术并发症,记录并计算手术前后国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）及残余尿量（PVR）等指标的差异。结果全部手术均成功,平均手术时间（40.8±7.5）min,术中出血量（60.0±12.0）mL,无输血病例。术后平均留置尿管时间（3.0±1.0）d。术后随访3月,IPSS及QOL评分由术前平均24.6±4.5及5.2±0.2分别下降至6.8±1.2及1.4±0.3,Qmax由术前（4.3±0.5）mL/s增加至术后（18.6±1.5）mL/s,PVR由术前（60±0.5）mL下降至术后（15.6±4.6）mL,手术前后比较均有显著性差异（P〈0.01）。术后无尿失禁及继发性出血。结论 2μm激光前列腺汽化切除术治疗高龄高危BPH安全有效。

Objective To explore the safety and efficacy of two micron continuous wave laser vaporesection for the treatment of high-risk senior patients with benign prostatic hyperplasia（BPH）.Methods 65 high-risk senior patients with obstructive BPH were treated with the RevoLix 70 Watt 2 micron continuous wave laser vaporesection.The patients＇ age ranged from 80 to 92 years,with a mean of（84.6±2.7） years.The operative time,blood loss,indwelling catheterization and operative complications were observed.The variables such as IPSS,QOL,Qmax,PVR were recorded and calculated pre-and post-operatively.Results The two micron continuous wave laser vaporesection was successfully performed on all the 65 patients.The mean operative time was（40.8±7.5） min and intraoperative blood loss was（60.0±12.0） mL.No patients required blood transfusion.The average postoperative catheterization time was（3.0±1.0） days.All cases were followed up for 3 months.IPSS and QOL scores decreased from preoperative 24.6±4.5 and 5.2±0.2 to postoperative 6.8±1.2 and 1.4±0.3 respectively,Qmax increased from（4.3±0.5） mL/s to（18.6±1.5） mL/s,and PVR decreased from（60±0.5） mL to（15.6±4.6） mL.There were significant differences between these parameters pre-and post-operation（P0.01）.No urinary incontinence or hemorrhage occurred after the operation.Conclusions Two micron continuous wave laser vaporesection of the prostate is a safe and effective procedure in treatment of high-risk senior patients with BPH.