经尿道160W直光束绿激光前列腺汽化切除术治疗大体积前列腺的疗效观察

Curative effectiveness of 160W direct green-light high performance system laser for photo-selective vaporization of prostate in treating large-volume prostate

目的评估经尿道160W直光束绿激光前列腺汽化切除术治疗大体积前列腺(>80ml)的临床疗效及安全性。方法回顾性分析2012年1月至2014年10月本院泌尿外科收治的良性前列腺增生症(benign prostatic hyperplasia,BPH)的大体积前列腺(>80ml)患者70例,采用经尿道直光束绿激光前列腺汽化切除术进行治疗,比较并分析患者手术前及术后前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(quality of life,Qo L)、最大尿流率(maximum flow rate,Qmax)、膀胱残余尿量(postvoidresidual volume,PVR),并且记录术中/术后的手术并发症情况。结果所有手术均一次顺利完成,患者平均手术时间(100.08±27.58)分钟,平均留置尿管时间(3.09±0.86)天,平均术后住院时间(4.12±1.49)天。与术前相比,患者下尿路症状均得到明显改善,血红蛋白及电解质未发生明显变化。术后12个月IPSS、Qo L、Qmax、PVR改善明显(P<0.01)。围术期及术后12个月随访期内,并发症发生率较低。结论经尿道直光束绿激光前列腺汽化切除术治疗大体积前列腺是一种安全有效的微创治疗方法。

Absract： Objective To investigate the clinical effect and safety of 160W direct green-light high performance system laser for photo-selective vaporization of prostate in treating large-volume （〉80ml） prostate.MethodThis retrospective analysis included 70 BPH patients with the prostatic volume larger than 80 ml, all treated by160 W direct green-light high performance system laser. We comparatively analyzed the levels of hemoglobin and serum sodium before and after surgery, recorded intra-and post-operative complications, and followed up the patients at 6 and 12 months after operation for International Prostate Symptom Score （IPSS）,quality of life （QOL）,maximum flow rate （Qmax）,and postvoid residual urine volume （PVR）.ResultAll operations were successfully completed, the average operation time （100.08＋27.58） min, the average indwelling catheter time （3.09＋0.86）d and the average hospital stay （4.12＋1.49） d. Compared with preoperative, the lower urinary tract symptoms were significantly improved, hemoglobin and electrolytes did not change significantly. 12 months after surgery, IPSS, QoL, Qmax, PVR changes were statistically significant （P〈0.01）. During perioperative period and postoperative follow-up period, the incidence of complications was lower than that of the patients during the period of follow-up. ConclusionStraight out of light PVP is a safe and effective surgical endoscopic approach to the treatment of large-volume prostate in BPH patients.