经尿道半导体激光剥橘式前列腺切除术治疗良性前列腺增生

Transurethral diode laser resection of the prostate-tangerine technique for the treatment of benign prostatic hyperplasia

目的：探讨半导体激光剥橘式前列腺切除术治疗良性前列腺增生（BPH）的手术方法并评估其安全性和有效性。方法2014年7月至2015年5月共完成126例经尿道半导体激光剥橘式前列腺切除术。所有患者术前通过前列腺特异抗原（PSA）、直肠指检（DRE）、经直肠超声（TRUS）、残余尿量（PVR）、国际前列腺症状评分（IPSS）和尿动力学等检查诊断为 BPH。患者年龄（71.0±7.2）岁，B 超估计前列腺体积（58.6±13.3）ml，PVR （125.9±125.5）ml，术前 IPSS（21.0±6.5）分，最大尿流率（Qmax）（7.9±3.4）ml/ s。比较术前、术后血 Na ＋和血红蛋白（Hb）浓度改变。随访患者术后1、3个月的 IPSS、Qmax 和 PVR。结果手术平均时间为61 min，术前术后血Na ＋改变差异未见统计学意义（P〉0.05），术前、术后 Hb 改变差异有统计学意义（P〈0.05），但缺乏临床意义。术后无需膀胱冲洗，导尿管留置时间3~4 d。术后1个月 Qmax（12.2±4.1）ml/ s，IPSS（10.45±2.91）分，PVR （43.2±23.8）ml；术后3个月 Qmax（20.2±2.8）ml/ s，IPSS（6.97±1.92）分，PVR（12.5±8.4）ml，与术前比较差异均有统计学意义（P 均﹤0.05）。结论经尿道半导体激光剥橘式前列腺切除术治疗良性前列腺增生安全有效。

Objective To investigate the safety and efficacy of transurethral diode laser resection of the prostate-tangerine technique for the treatment of benign prostatic hyperplasia（BPH）. Methods From July 2014 to May 2015,126 patients diagnosed as BPH received transurethral diode laser resection of the prostate-tangerine technique. All of the patients accepted PSA,DRE,TRUS,PVR,IPSS and urodynam-ic examinations before surgery. The mean age was（71. 0 ± 7. 2）years,the mean prostate volume was （58. 6 ± 13. 3）ml and the mean PVR was（125. 9 ± 125. 5）ml. The average IPSS was 21. 0 ± 6. 5 and the average Qmax was（7. 9 ± 3. 4）ml/ s before operation. The values of serum sodium concentration and hemoglobin pre-operation and post-operation were compared. The IPSS,Qmax and PVR 1 and 3 months after surgery were recorded and compared. Results The mean operation time was 61 min,there was no＆amp;nbsp;significant difference in serum sodium concentration pre- and post-operation（P〉 0. 05）,and there was significant difference in hemoglobin concentration pre- and post-operation（P〈 0. 05）. The duration of bladder catheterization was 3 to 4 days. The average Qmax was（12. 2 ± 4. 1）,（20. 2 ± 2. 8）ml/ s,the average IPSS was 10. 45 ± 2. 91, 6. 97 ± 1. 92 and the average PVR was （ 43. 2 ± 23. 8 ）, （12. 5 ± 8. 4）ml at 1 and 3 months after surgery respectively. They all had significant differences com-pared with preoperation（P〈 0. 05）. Conclusions Transurethral diode laser resection of the prostate-tangerine technique for the treatment of benign prostatic hyperplasia is effective and safe.