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目的:评价经尿道980 nm红激光前列腺汽化切除术治疗BPH的有效性及安全性。方法:2010年6月~2011年12月,对24例经超声测得前列腺体积平均(68±18)ml的BPH患者行经尿道红激光前列腺汽化切除术,观察记录手术时间、术中出血量,术中灌注液体总量、术后留置尿管时间、手术并发症,记录手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))及剩余尿量(PVR)等指标,并与同期34例接受经尿道前列腺等离子电切术的前列腺增生患者的数据比较。结果:58例患者手术均获成功,激光组手术时间平均(75.2±28.5)min,术中平均出血量(10.1±3.2)ml,无输血病例;术后灌注液体总量平均(14.1±2.5)L。术后平均留置尿管时间(4.1±0.7)d。术后随访4~18个月,术后3个月复查IPSS评分由术前平均(22.7±4.7)下降至(9.2±1.5)分,Q_(max)由术前(6.5±2.7)ml/s增加至术后(18.3±3.3)ml/s,PVR由术前(63.6±10.2)ml下降至术后(25.9±6.7)ml,手术前后比较差异均有统计学意义(P<0.01)。与等离子电切组对比,红激光组在术中出血量及术中灌注液体总量方面显著少于等离子电切组,手术时间长于等离子电切组,而其他指标差异无统计学意义。24例术前仍保持性功能者,术后均保留性功能。术后无尿失禁发生。结论:经尿道红激光汽化切除术治疗BPH安全有效,尤其适合于高龄、高危患者,但其长远疗效还需进一步观察。
Objective: To evaluate the efficacy and safety of transurethral resection of 980 nm red laser prostatectomy for the treatment of BPH. Methods: From June 2010 to December 2011, 24 cases of BPH with an average of (68 ± 18) ml in the mean prostate volume underwent transurethral resection of the prostate by vaporization of the prostate. The operation time, amount of intraoperative bleeding, The total amount of intraoperative fluid perfusion, postoperative indwelling catheter time, operative complications, IPSS, QOL, Qmax and residual urine volume before and after surgery were recorded. (PVR) and other indicators, and with the same period in 34 cases of transurethral prostatectomy prostate benign prostatic hyperplasia patients data comparison. Results: Fifty-eight patients were successful in operation. The average operation time was 75.2 ± 28.5 minutes in the laser group and 10.1 ± 3.2 ml in the operation group, L. Postoperative average indwelling catheter time (4.1 ± 0.7) d. The postoperative follow-up ranged from 4 to 18 months. The IPSS score decreased from (22.7 ± 4.7) to (9.2 ± 1.5) points preoperatively at 3 months postoperatively, and the Q max decreased from 6.5 ± 2.7 ml / s preoperatively (18.3 ± 3.3) ml / s postoperatively, the PVR decreased from 63.6 ± 10.2 ml to 25.9 ± 6.7 ml postoperatively, and the difference was statistically significant before and after operation (P <0.01). Compared with the plasma electrosurgical group, the red laser group was significantly less than the plasma electrosurgical group in the amount of intraoperative blood loss and intraoperative perfusion liquid, the operation time was longer than the plasma electrotome, while the other indexes had no statistical significance. Twenty-four patients still maintained their sexual function before surgery, and retained their sexual function after surgery. Postoperative urinary incontinence occurred. Conclusion: Transurethral vapor-assisted laser vaporization is safe and effective in the treatment of BPH. It is especially suitable for elderly and high-risk patients, but its long-term efficacy needs further observation.