选择性绿激光前列腺汽化术的临床研究:附77例报告

Photoselective vaporization of prostate for the treatment of benign prostatic hyperplasia: report of 77 cases

目的评价使用国产绿激光行选择性绿激光前列腺汽化术治疗良性列腺增生症的有效性和安全性。方法 2006年1月至2011年10月我科应用国产医用绿激光系统对77例良性前列腺增生患者进行选择性绿激光汽化术,观察手术时间、术前术后血清钠、血红蛋白、术后留置尿管时间、最大尿流率、国际前列腺症状评分(IPSS)、生活质量评分(QOL)的变化。结果平均手术时间54min,汽化效果良好,术后平均留置尿管55h,QOL评分术前5.21±0.59,术后1个月和6个月降至0.81±0.67和0.66±0.58,IPSS评分术前25.18±4.46,术后1个月和6个月降至7.04±1.99和6.32±1.72,最大尿流率术前4.88±2.15ml/s,术后1个月和6个月升至17.63±7.37ml/s和18.20±5.29ml/s,血红蛋白和血清钠水平术前术后稳定,无TUR综合征和尿失禁等并发症。结论国产绿激光进行选择性绿激光前列腺汽化术治疗良性列腺增生症安全、有效。

Objectives To evaluate the safety and efficacy of photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia using domestic high power KTP laser. Methods Seventy-seven consecutive patients with symptomatic benign prostatic hyperplasia underwent photoselective vaporization of the prostate with domestic high power KTP laser between January 2006 and October 2011. The operative time, indwelling catherization and preoperative/postoperative serum sodium and hemoglobin were recorded. The international prostate symptom score, quality of life, maximal flow rate were measured at each follow-up visit. Results The mean operative time was 54 min, the mean time of indwelling catheter was 55 hours. Quality of Life decreased from 5.21±0.59 preoperatively to 0.81±0.67 and 0.66±0.58 postoperatively. The international prostate symptom score decreased from 25.18 ±4,46 preoperatively to 7.04 ±1.99 and 6.32±1.72 postoperatively, the maximal flow rate increased from 4.88±2.15 ml/s preoperatively to 17.63±7.37 ml/s and 18.20±5.29ml/s postoperatively. The serum sodium level and hemoglobin did not change significantly. Conclusion Photoselective vaporization of the prostate with domestic high power KTP laser is safe and effective for men with symptomatic benign prostatic hyperplasia.