经尿道160W绿激光前列腺汽化术治疗良性前列腺增生疗效观察

Curative effect of 160 W PVP in the treatment of benign prostatic hyperplasia

目的:观察经尿道160 W绿激光前列腺汽化术治疗BPH的临床疗效及其并发症。方法:选择62例BPH患者使用160 W绿激光侧出光纤行经尿道前列腺绿激光汽化术,观察患者的手术时间、术中出血量、手术前后血钠水平、术中术后并发症、术后膀胱冲洗时间、术后24 h的血降钙素原(PCT)水平、术后留置尿管时间、术后住院时间,术前及术后3、6个月、1年检测RUV、Qmax、IPSS及QOL评分。结果:所有患者手术顺利,平均手术时间为(61.5±14.1)min;平均术中出血量为(15.5±2.7)ml;术后平均即刻血钠为(138.8±3.3)mmol/L,与术前相比差异无统计学意义(t=0.049,P=0.961>0.05);术中术后无前列腺电切综合征、输血、尿失禁、尿道狭窄并发症的发生,术后平均膀胱冲洗时间为(15.8±2.6)h;术后平均PCT为(0.37±0.09)μg/L;术后平均留置导尿时间为(2.9±0.5)d;术后平均住院时间为(4.1±0.8)d;出院1周后发生尿路感染21例,发生率为33.87%;术后3、6个月、1年随访RUV、Qmax、IPSS、QOL与术前比较均P<0.05。结论:经尿道160 W绿激光前列腺汽化术治疗BPH安全、有效,并发症少,但术后尿路感染发生率高。

Objective: To observe the clinical efficacy and complications of 160 W green laser prostate vaporization in the treatment of benign prostatic hyperplasia. Methods: Sixty-two cases of benign prostatic hyperplasia were treated with 160 W green laser side-out fiber for transurethral vaporization of the prostate. The following parameters were observed: the operating time,intraoperative blood loss,blood sodium levels pre-and post-operationg,intraoperative and postoperative complications,bladder irrigation time,PCT level in 24 h after operation,postoperative indwelling catheter time,postoperative hospital stay,and RUV,Qmax,IPSS,QOL score before and 3 months,6 months,1 year after operation. Results: All the operations were performed successfully. The mean operating time was( 61. 5±14. 1) min,the mean intraoperative hemorrhagic volume was( 15. 5±2. 7) m L,and the mean instant blood sodium was( 138. 8±3. 3) mmol/L after operation,which showed no significant difference from those before operation. No prostatic electrotomy syndrome,blood transfusion,urinary incontinence and urethral stricture were found intraoperatively and postoperatively. The mean bladder irrigation time was( 15. 8±2. 6) h after operation,the mean PCT was( 0. 37± 0. 09) μg/L after operation,the mean postoperative catheterization time was( 2. 9±0. 5) days,the mean postoperative hospital stay was( 4. 1±0. 8) days.There were 21 cases of urinary tract infection in 1 week after discharge,and the incidence rate was 33. 87%. Before and3 months,6 months,1 year after operation,there were significant differences in RUV,Qmax,IPSS,QOL score(P<0. 05 for all). Conclusions: Application of 160 W green laser through the urethral prostate vaporization is effective in thetreatment of benign prostatic hyperplasia,and the incidence of complications is low,but the incidence of urinary tract infection is high.