经尿道1 470 nm激光汽化切除术治疗高龄高危BPH研究

The Study of Transurethral 1 470 nm Laser Vaporectomy for the Treatment of High Risk BPH in the Elderly

目的总结经尿道1 470 nm激光汽化切除术治疗高龄高危BPH临床经验。方法回顾性分析采用经尿道1 470 nm激光汽化切除术治疗的高龄高危BPH患者36例的临床资料。结果所有患者手术均获得成功,手术时间为(90.12±21.12)min,术中出血量为(31.15±15.62)ml,术中无前列腺穿孔等并发症的发生。术后7天拔除尿管,无尿潴留发生,无继发性出血。术后随访6个月,无尿道狭窄等并发症发生。术后第3个月时,患者国际前列腺评分由术前(23.19±2.34)分降至术后(10.12±1.15)分(P<0.05),生活质量评分由术前(5.15±0.69)分降至术后(1.12±0.15)分(P<0.05),最大尿流率由术前(5.22±1.18)ml/s升至术后(14.12±0.98)ml/s(P<0.05),膀胱残余尿量由术前(90.52±20.56)ml降至术后(19.56±9.95)ml(P<0.05)。结论经尿道1 470 nm激光汽化切除术是治疗高龄高危BPH一种安全、有效的方法。

Objective To summarize the clinical experience of transurethral resection of 1 470 nm laser vaporization for the treatment of high risk BPH in the elderly. Methods Retrospective analysis of the clinical data of 36 cases of high risk elderly BPH patients treated with transurethral 1470 nm laser vaporization resection was carried out. Results All the operations were successful, the operative time was （90.12±21.12） min, the intraoperative blood loss was （31.15±15.62） ml, no intraoperative prostatic perforation and other complications occurred. 7 days after the operation, urethral catheter was removed, no urinary retention occurred, no secondary bleeding. After 6 months of follow-up, no complications such as urethral stricture were found. At third months after the operation, the international prostate score was reduced from （23.19±2.34） to postoperative （10.12±1.15） scores （P 〈 0.05）. The score of quality of life was reduced from （5.15 ±0.69） to postoperative （1.12 ± 0.15） （P〈 0.05）. The maximum urine fow rate was increased from （5.22±1.18） ml/s before operation （14.12±0.98） ml/s （P 〈 0.05）. The residual urine volume of bladder decreased from （90.52±20.56） ml to postoperative （19.56±9.95） ml （P 〈 0.05）. Conclusion Transurethral resection of 1470 nm laser vaporization is a safe and effective method for the treatment of high risk BPH in the elderly.