120W2μm激光前列腺汽化切除术治疗良性前列腺增生的疗效分析

Application of 120 W 2 μm laser prostate vaporesection in the treatment of benign prostatic hyperplasia

目的观察120W2μm激光前列腺汽化切除术治疗良性前列腺增生（BPH）的安全性和疗效。方法需外科手术治疗的BPH患者41例，年龄57～88岁，平均71岁。B超检查测量胁列腺体积27～95ml，平均（58．5±19．4）ml。接受120W2μm激光前列腺汽化切除术。比较患者手术前、后IPSS、QOL、Qmax和残余尿量（PRV）等指标。评估手术时间、出血量、电解质变化及术后并发疗的情况。结果41例患者均一次成功完成手术。平均手术时间为（32．9±10．7）min，血红蛋白平均下降（5．36±2．78）g／L。所有患者未输血，未发生电解质紊乱。术后平均留置尿管时间（2．5±0．7）d。术后下尿路梗阻症状均有缓解。术前IPSS 25．3±5．4、QOL 4，8±1．1、Qmax（8．0±3．2）ml、PVR（75．0±29．9）ml。术后1、6和12个月[PSS分别为7．2±4．7、5．3±4．5、4．5±4．0；Q01分别为2．2±1．5、1．4±1．3、1．1±1．1。无再次于术，术后随访12个月术出现尿失禁和膀胱颈挛缩等并发症。结论2μm激光前列腺汽化切除术可明显改善BPH患者下尿路梗阻症状，手术失血量少，手术时间短，围手术期安全，远期疗效可靠。

Objective To study the safety and clinical efficacy of transurethral 120 W 2 μm laser prostate vaporesection in the treatment of benign prostatic hyperplasia （BPH）. Methods Forty-one BPH cases were treated with 2 μm continuous wave laser prostate vaporescetion. Laser output power was 120 w. International prostate symptom scores （IPSS） were collected on all patients before and after surgery at one, six and 12 months for maximum urinary flow rate （Qmax） and post-voiding residual urine volume （PVR）. Operative time, estimated bleeding loss, electrolyte changes, and the time of catheter removal were recorded and analyzed respectively. Results All procedures were successfully completed. The obstructive symptoms of lower urinary tract symptoms were relieved in varying degrees post-operatively. Preoperative and postoperative one, six and 12 months IPSS, Qmax and PVR showed statistical difference （ P 〈 0.01 ）. Operative time was 32.9 ±10.7 min, decreased hemoglobin levels was 5.36 ± 2.78 g/L, no cases needed blood transfusion, and all patients were without electrolyte disturbance resulted in the safe perioperative period. The time of removal of the catheter was 2.5 ± 0.7 d. There was no secondary surgery, urinary incontinence, and complication such as bladder neck contracture at 12 months post-operative follow-up. Conclusions BevoLix 2 μm continuous wave laser prostate vaporesection as a treatment option for BPH is safe and effective over a short and long period of time. RevoLix 2 μm wave laser prostate vaporesection can significantly improve BPH patient symptoms of lower urinary tract obstruction.