选择性120W绿激光汽化术治疗大腺体良性前列腺增生症的近期疗效观察

The recent clinical efficacy study of photoselective vaporization of prostate （ 120 W） for treatment of large gland benign prostatic hyperplasia

【目的】探讨选择性120 W绿激光汽化术治疗大腺体前列腺增生症（BPH）的近期临床安全性及有效性。【方法】统计分析2010年7月至2012年1月112例应用120 W绿激光汽化术治疗大腺体BPH（前列腺质量＞75 g）患者的临床资料，观察手术前后症状缓解及并发症发生情况，分析近期临床疗效。【结果】手术均顺利完成，未发生经尿道电切综合征，术中、术后无输血病例，手术操作平均时间（52.6±12.1）min，术中平均出血量（27.4±18.5）ml，术后膀胱冲洗时间（19.4±7.3）h，术后留置尿管时间平均（3.2±0.6）d，术后平均住院时间（4.8±1.3）d。术后国际前列腺症状评分（t=52.24～59.10）、生活质量评分（t=48.42～53.63）、最大尿流率（t=－31.01～－24.23）及残余尿量（t=9.85～12.53）均较术前显著改善（P〈0.01）。【结论】经尿道选择性120 W绿激光前列腺汽化术治疗大腺体BPH具有操作安全、术中出血少、近期疗效显著，尤其适合于高龄高危患者。

Objective To explore the recent clinical safety and efficacy of photoseleetive vaporization of prostate （ 120 W ） for the treatment of large gland benign prostatic hyperplasia. Methods The clinical data of 112 cases who accepted photoselective vaporization of prostate （ 120 W） for the treatment of severe benign prostatic hyperplasia （the weight of prostate 〉 75 g） from July 2010 to January 2012 was statistical analyzed. Relief symptoms and complications were observed around surgery, and the recent clinical efficacy was analyzed. Results All the operations were smooth. There were not transurethral resection syndrome. No cases need transfusion intraoperative and postoperative. The operation average time was （52. 6 ± 12. 1 ） minutes, and the average amount of bleeding was （27.4 ± 18.5） ml. The postoperative bladder irrigating time was （19.4 ± 7.3 ） hours, the mean postoperative indwelling catheter time was （3.2±0.6） days, and the mean postoperative hospital stay was （4. 8 ± 1.3 ） days. Postoperative international prostate symptom score （t = 52. 2±59. 10） , quality of life （t =-48.42-53.63 ）, maximum flow rate （ t = - 31.01- - 24. 23 ） and residual urine volume （ t = 9.85-12. 53 ） compared with preoperative are significantly improved （ P 〈 0. 01 ）. Conclusions With the safe operation of photoseleetive vaporization of prostate （ 120 W） for the treatment of large gland benign prostatic hyperplasia, it is less bleeding, recent efficacy is significant, and it is especially appropriate to elderly patients at high risk of large gland.