经尿道绿激光膀胱颈汽化术治疗女性原发性膀胱颈梗阻的临床研究

A Clinical Study on Transurethral Bladder Neck Vaporization with GreenLight Laser for the Treatment of Primary Bladder Neck Obstruction in Female Patients

目的评估采用经尿道绿激光膀胱颈汽化术治疗女性原发性膀胱颈梗阻（primary bladder neck obstruction,PBNO）的可行性及临床疗效。方法回顾性分析山东大学附属省立医院泌尿微创中心自2012年1月至2015年1月收治的55例女性原发性膀胱颈梗阻患者,采用经尿道绿激光膀胱颈汽化术进行治疗,记录并分析这些患者的术中、术后各项指标,评估手术治疗的效果。结果 55例患者手术均获成功,术中无明显出血,平均手术时间22分钟（1530分钟）,术后最大尿流率(maximum uroflow rate,Qmax)（21.3±5.16）ml/s（14.726.9ml/s）,排尿后平均膀胱残余尿量（postvoid residual,PVR）由术前（112.4±87.3）ml减少至（24.3±15.4）ml,术后最大尿流率时达到的逼尿肌压由术前的（67.22±12.33）cmH2O减至（21.07±7.52）cmH2O。55例患者的排尿功能均得到明显改善,无术中、术后严重并发症出现。结论对女性原发性膀胱颈梗阻患者采用经尿道绿激光膀胱颈汽化术是一种易于操作、创伤小、疗效好、并发症少的手术方法,值得推广。

Objective To evaluate the feasibility and clinical effect of the transurethral bladder neck vaporization with Green Light laser for the treatment of primary bladder neck obstruction( PBNO). Methods Retrospective analysis of the clinical data of 55 female patients with PBNO who were treated with transurethral bladder neck vaporization with GreenLight laser from Jan 2012 to Jan 2015. The operative related data were collected and analyzed to evaluate the efficacy. Results All these 55 patients underwent the operations successfully without obvious bleeding during operations. The average operation time was 22 minutes( ranged from 15 to 30 minutes),and the average maximum uroflow rate( Q_(max)) after the operation was( 21. 3 ± 5. 16) ml/s( ranged from 14. 7 to26. 9ml/s). After operations,the average post-void residual( PVR) and the maximal detrusor pressure were both significantly decreased. There was no complication occurred peri-operatively. The voiding functions have been improved in all 55 patients. Conclusions Transurethral bladder neck vaporization with Green Light laser for primary bladder neck obstruction is a safe approach which is simple,minimally invasive and highly effective.