低能量钬激光与传统冷刀治疗尿道狭窄的疗效研究（附59例报告）

Low-power holmium laser urethrotomy for urethral stricture：compared with cold-knife（a report of 66 cases）

目的：评估低能量钬激光尿道内切开治疗尿道狭窄的安全性及有效性。方法回顾性分析2007年到2010年因外伤性尿道狭窄首次就诊的59例患者。钬激光治疗组31例，冷刀治疗组28例，分别于狭窄环3点、9点及12点处切开。评估患者术前IPSS及QoL，最大尿流率（Qmax），分别于术后3、6、9、12个月时评估手术效果及无复发率。结果59例患者均顺利完成手术，钬激光治疗组手术时间明显短于冷刀治疗组。术后3个月及6个月时，两组患者术后无复发率相似，而术后9个月及12个月时，钬激光治疗组无复发率（35.5%）明显高于冷刀治疗组（28.6%）。结论钬激光尿道内切开治疗尿道狭窄是安全有效的，其术后复发出现较冷刀治疗晚，但仍存在较高的复发率。

Objective To evaluate the safety and efficacy of low-power holmium laser urethrotomy for urethral stricture. Methods Clinical data of 59 patients with urethral stricture for first time between 2007 to 2010, were analyzed retrospectively. Thirty-one patients of them received urethrotomy with low-power holmium laser at 3, 9 and 12 o’clock position, and 28 patients received urethrotomy with conventional cold-knife at 3, 9 and 12 o’clock. The scores of IPSS, QoL and Qmax were measured to assess the efficacy of treatment and the recurrence rate after the management. Qmax and recurrence-free rate at 3, 6, 9 and 12 months postoperatively were comparatively analyzed. SPSS 13.0 was used for statistical analysis, and P＆lt;0.05 was as statistical significance. Results All operations for 66 patients were successful. Average operation time in laser group was shorter than that in cold-knife group（P＆lt;0.05）. Recurrence-free rates at 3 and 6 month were no differences between two groups. Recurrence-free rate at 9 and 12 months in cold-knife group were higher than that in laser group. Conclusion Holmium laser is a safe and effective method for the management of urethral stricture. It shows shorter operation time and higher recurrence-free rate as compared with cold-knife technique.