高原地区Nd∶YAG接触式激光治疗前列腺增生症

Nd∶YAG Contact Laser Treatment of Benign Prostatic Hyperplasia at Plateau Patients

目的 探讨高原地区Nd∶YAG 接触式激光治疗前列腺增生症(BPH) 的效果。方法 86 例BPH 患者年龄56 ～83 岁,平均68-5 岁。Ⅰ度增生8 例,Ⅱ度增生36 例,Ⅲ度增生42 例,有63 例残余尿量为50 ～400 ml,平均80 ml。在硬膜外麻醉或骶麻下接受Nd∶YAG 接触式激光治疗,激光输出功率50 W,治疗时间5 ～15 min 。结果 第1 次激光治疗后80 例患者(93-0 % ) 恢复自主排尿,其中3 ～10 天恢复排尿者72 例(83-7 % ) ,21 天恢复排尿者8 例(9-3 % ) 。6 例(7-0 % ) 首次治疗拔管后不能排尿,2 周后行再次激光治疗,2 例恢复排尿,3 例行膀胱穿刺造瘘,1 例改行开放手术。术后夜尿次数由术前平均4 次减少至2 次。63 例残余尿量大于50 ml 者中,47 例(74-6 % ) 术后恢复正常。平均住院天数10 天(2 ～14 天) 。所有病人随访3 ～22 个月( 平均8 个月) ,无发生尿失禁及严重泌尿系感染者。结论 Nd∶YAG 接触式激光治疗BPH 的适应证宽,安全性高,近期疗效肯定,适用于高原地区老年BPH 患者。

Objective To evaluate the results of transurethral contact Nd∶YAG laser treatment for benign prostatic hyperplasia(BPH) at high altitude. Methods 86 patients with BPH were treated by transurethral contact laser treatment since July 1996 to July 1998. The Nd∶YAG laser output power was 50 W. The treating time was 5-15 min. Results 72 cases(83 7%) had recovered urination in 3 to 10 days and 8 cases(9 3%) in 21 days post treatment, another 6 cases(7 0%) couldn't make urination post decannulation. Nocturia was decreased from 4 times before treatment to 2 times post treatment by averge. 63 cases Among with residual urine more than 50 ml, 47 cases(74 6%) recovered normal urination and all other patients had improvement. The hospitalization days was 2-14 days, average 10 days. All patients were followed up for 3 to 22 months(average 8 months), the effective rate was 93 0%(80/86). Conclusions Our findings indicate that Nd∶YAG laser therapy may be considered as a safe and effective therapeutic modality and can be used for BPH treatment. This technique showed advantages of less bleeding and injury, effective coagulation and vaporization, less painful and rapid recovery. The short term results were excellent. It is widely suitable for patients with BPH in poor condition or in elder age, especially it offers an ideal method to treat BPH patient at altitude.