1470nm激光汽化前列腺的效果评价和疗效随访

The Effect Evaluation and Follow-up of 1470 nm Laser Vaporization of the Prostate

目的 评价1 470 nm激光治疗膀胱出口梗阻前列腺增生患者的可行性。方法 本研究中入组60例患者,使用1 470 nm激光进行前列腺汽化,使用相关参数进行评价,其中包括：IPSS评分,生活质量,最大尿流率,残余尿等分别进行术前、术后半年的疗效评价。结果60例患者,前列腺体积38~84 ml,平均（55±18.6）ml。未出现大出血或液体过度吸收等情况。三腔尿管移除时间2~4 d,平均为术后2.5 d。最大尿流率从术前（4.5±1.3）ml/s提升为术后6月的（26.8±4.3）ml/s（P〈0.05）。残余尿由术前平均（203±145.6）ml到术后6月的（23.4±9.7）ml（P〈0.01）。PSA由术前（3.8±1.3）ng/ml降至术后6月的（2.1±1.6）ng/ml。随访过程中,所有患者排尿功能恢复良好,均未出现尿失禁。其中2例患者去除尿管后因尿道水肿,再次尿管留置1~2 d。所有患者半年后随访,对排尿效果均满意。结论 1 470 nm激光的汽化治疗前列腺增生是有效和可靠的。

Objective To evaluate the effect of 1470nm laser vaporisation of prostate in patients with bladder outlet obstruction （BOO）.Methods 60 patients were included in this pilot study. The prostate was vaporised by 1 470 nm leaser （100W）.IPSS, quality of life, Qmax, and PVR volume were measured preoperatively and half year after the intervention.Results Prostate volumes were 38~84ml, mean value was （55±18.6）ml.No patient had significant blood loss or fluid absorption. Three-way catheters were removed after a median of 2.5 d （2~4 d）. Qmax increased from （4.5±1.3）nbsp;ml/s preoperatively to （26.8±4.3）ml/s （P〈0.05） postoperatively. PVR volume changed from a baseline of （203±145.6） ml to （23.4±9.7）ml after 6 months （P〈0.01）. PSA levels before surgery （3.8±1.3） ng/ml and after 6 months （2.1±1.6）ng/ml. No patient was incontinent. Two patients required recatheterisation postoperatively on days 1~2.All patients without reintervention had presented for the 6 months follow-up examination and were satisifed with the outcome. Conclusion 1 470 nm laser vaporization prostatectomy is feasible and appears to be effective for BOO.