经尿道绿激光分叶剜除汽化术治疗良性前列腺增生14例

Application of transurethral enucleation and vaporization using 160W Greenlight laser with straight light beam in 14 patients of benign prostatic hyperplasia

目的探讨经尿道直出160 W绿激光前列腺分叶剜除汽化术的手术技巧,评价其治疗良性前列腺增生的安全性和有效性。方法 2014年8月至2015年8月,应用160 W医用绿激光手术系统,采用直出绿激光光纤行前列腺分叶剜除汽化术治疗前列腺增生患者14例。通过观察手术前后国际前列腺症状评分(IPSS)、生活质量指数评分(QOL)、血清血红蛋白和最大尿流率等指标变化,评价经尿道直出160 W绿激光前列腺分叶剜除汽化术的临床效果。结果本组患者中位年龄69岁,所有手术均成功,术中未见明显出血,无TUR综合征等并发症发生。术后拔除尿管后患者均自行排尿通畅,无尿失禁发生。手术前后平均血红蛋白水平比较差异无统计学意义(P>0.05),术后3个月,IPSS和QOL评分分别降至(4.9±2.74)分和(1.3±1.35)分,Qmax提升至(16.5±7.54)m L/s,与术前比较差异均具有统计学意义(P<0.05)。结论经尿道直出160W绿激光前列腺分叶剜除汽化术治疗良性列腺增生症安全有效。

Objective To discuss the surgical techniques of transurethral enucleation and vaporization using 160 W Greenlight laser with straight light beam, and evaluate its safety and efficacy for treating in benign prostatic hyperplasia(BPH). Methods Fourteen patients diagnosed as BPH with operation indications were treated by transurethral enucleation and vaporization using 160 W Greenlight laser with straight light beam from Aug 2014 to Aug 2015. Through observing the changes of international prostate symptom score(IPSS), quality of life index(QOL) score, serum hemoglobin and maximum urinary flow rate before and after operation, the clinical effect of the treatment were evaluated. Results The median age of the patient was 69, and all operations were successfully performed without any complications, such as bleeding and ransurethral resection syndrome(TURS). No dysuria and incontinence occurred after removing catheter. There was no significant difference in the average hemoglobin level before and after surgery(P>0.05). Three months after operation, the IPSS and QOL scores were significantly decreased to(4.9±2.74) and(1.3±1.35), and the Qmax was significantly raised to(16.5±7.54) m L/s. The differences were statistically significant(P<0.05). Conclusion Transurethral enucleation and vaporization of BPH using 160 W Greenlight laser with straight light beam is safe and effective for treating BPH.