2μm激光治疗长期口服抗凝药物良性前列腺增生临床观察

2 μm laser in treating benign prostatic hyperplasia with long- term anticoagulative therapy

目的：探讨2μm 激光治疗长期口服抗凝药物良性前列腺增生患者的安全性及有效性。方法：对28例长期服用抗凝药物良性前列腺增生患者行经尿道前列腺2μm 激光“刀削面”式汽化切除术。结果：手术时间为30～70min，平均时间（45±13）min；术后持续膀胱冲洗1～3d；留置尿管2～6d，膀胱造瘘管于拔出尿管后次日拔出；术后住院时间4～7d。术后随访3～6个月，术前与术后6个月平均 IPSS 分别为：（22.7±4.5）分、（6.8±3.5）分；QOL 分别为：（5.2±0.4）分、（2.2±1.2）分；Qmax 分别为：（6.4±1.5）mL／s、（18.8±3.2）mL／s，上述三项指标与术前比较，均有明显改善（P ＜0.01）。结论：经过严格术前评估与恰当处理，2μm 激光治疗长期口服抗凝药物良性前列腺增生患者安全有效。

Objectives：To analyze the technical properties and safety of 2μm laser in the management of benign prostatic hyperplasia with long -term anticoagulative therapy.Methods：28 patients with obstructive BPH and long -term anticoagulative therapy were treated transurethrally by the ‘sliced noodles -vaporesection’tech-nique using the Revolix70 W 2μm continuous laser.Results：The mean operation time was （45 ±1 3）（30 -70） min;mean continuous bladder irrigation time was 1 ~3d;mean catheter time was 2 ~6d;mean hospitalization time was 4 -7d.All patients were followed up for 3 to 6 months,and IPSS and QOL -Score improved from （22.7 ± 4.5）and （5.2 ±0.4）to （6.8 ±3.5）and （2.2 ±1 .2）respectively at six months after operation （P 〈0.05）. Mean Qmax increased from （6.4 ±1 .5）mL/s preoperatively to （1 8.2 ±3.2）mL/s 6 months postoperatively （P 〈0.05）.Conclusion：With strict preoperative evaluation and management,2μm continuous laser is safe and effec-tive in treating benign prostatic hyperplasia with long -term anticoagulative therapy.