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目的:探讨2μm激光前列腺切除术治疗高龄前列腺增生患者的临床疗效及安全性。方法:选取2010年7月~2012年7月采用2μm激光治疗的前列腺增生患者106例,年龄70~89岁,平均(82.8±9.6)岁。激光功率为70 W。观察围手术期手术时间、术后拔除尿管时间和膀胱冲洗时间;比较术前、术后24小时血红蛋白和电解质的变化及围手术期安全性;评估治疗前及治疗后3个月国际前列腺症状评分(IPSS)、膀胱过度活动症状评分(OABSS)、生活质量评分(QOL)的改善情况。结果:手术时间32~128min,平均(69.0±12.4)min;拔除尿管时间3~5d,平均(3.6±0.7)d;,膀胱冲洗时间18~28h,平均(23.0±5.1)h。术前、术后血红蛋白和电解质的无明显变化。围手术期未发现心、脑及肺等严重并发症。治疗后3个月IPSS、OABSS、QOL评分均低于治疗前,差异有统计学意义(P<0.05)。结论:高龄前列腺增生患者采用2μm激光治疗,其围手术期安全性明显、手术时间短,拔除尿管和膀胱冲洗时间短,术后恢复快,疗效显著。
Objective: To investigate the clinical efficacy and safety of 2 μm laser prostatectomy in the treatment of elderly patients with benign prostatic hyperplasia. Methods: From July 2010 to July 2012, 106 patients with benign prostatic hyperplasia treated with 2μm laser were selected, aged from 70 to 89 years (average, 82.8 ± 9.6) years. Laser power is 70 W. The duration of perioperative surgery, the duration of catheter removal and bladder irrigation after operation were observed. The changes of hemoglobin and electrolytes and perioperative safety at 24 hours before and after surgery were compared. Prostate symptoms were assessed before and 3 months after treatment Score (IPSS), overactive bladder symptom score (OABSS) and quality of life score (QOL). Results The operation time was 32 to 128 minutes (mean, 69.0 ± 12.4) min. The duration of catheter removal was 3 to 5 days (average, 3.6 ± 0.7). The bladder flushing time was 18 to 28 hours (mean, 23.0 ± 5.1) h. Preoperative and postoperative hemoglobin and electrolyte no significant change. Perioperative period found no serious complications such as heart, brain and lung. The scores of IPSS, OABSS and QOL at 3 months after treatment were all lower than those before treatment, the difference was statistically significant (P <0.05). CONCLUSIONS: The patients with benign prostatic hyperplasia are treated with 2μm laser and the perioperative safety is obvious. The operation time is short, the catheter and bladder flushing time are short, the postoperative recovery is rapid and the curative effect is obvious.