摘要
目的:分析超脉冲光纤铥激光前列腺剜除术(SPThuFLEP)治疗前列腺增生(BPH)的安全性和有效性,探索SPThuFLEP最佳的参数组合。方法:回顾性分析2022年11月—2022年12月因BPH行SPThuFLEP患者的临床资料,SPThuFLEP全部采用“三叶法”,剜除用脉冲波,平均功率为55 W,止血用连续波,平均功率为60 W,脉冲波参数设置为3组:(1)1 J×55 Hz;(2)1.5 J×36.7 Hz;(3)2 J×27.5 Hz。观察术前与术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))变化,分析不同参数组剜除效率及手术疗效差异。结果:纳入18例患者,平均年龄(70.5±2.3)岁,全部完成手术及术后随访。平均剜除手术时间(75.0±5.3)min,平均止血时间(5.8±0.4)min,平均剜除组织重量(47.9±5.6)g,平均剜除效率(0.6±0.05)g/min,无术中并发症发生;术后第1天平均血红蛋白下降值(6.3±1.1)g/dL,平均留置尿管时间(4.4±0.3)d,术后3个月随访时,平均Q_(max)(22.6±0.8)mL/s,平均IPSS评分(4.3±0.8)分,平均QoL评分(0.9±0.2)分;1例患者出现反复尿路感染,3例有性生活患者均出现逆向射精,无长期尿失禁、尿道狭窄等并发症。结论:SPThuFLEP治疗BPH安全有效,不同参数设置对SPThuFLEP效率及效果的影响不大。
Objective To analyze the safety and effectiveness of super pulsed thulium fiber laser enucleation of prostate(SPThuFLEP)in the treatment of benign prostatic hyperplasia(BPH),and to explore the optimal parameter in SPThuFLEP.Methods We retrospectively analysed the data of patients who received SPThuFLEP due to BPH from November 2022 to December 2022.All patients were treated with'three-leaf'method SPThuFLEP,with pulse wave for enucleation(55 W)and continuous wave for hemostasis(60 W).Pulse wave parameters were set as 1 J×55 Hz,1.5 J×36.7 Hz,2 J×27.5 Hz respectively.The changes of international prostate symptom score(IPSS),quality of life(QoL)score and maximum urinary flow rate(Q_(max))before and after operation were observed.Enucleation efficiency and surgical efficacy were analyzed in different parameter groups.Results A total of 18 patients were included,with an average age of(70.5±2.3)years.All patients completed the operation and were followed up after the operation.The mean time of enucleation was(75.0±5.3)min,and the mean time of hemostasis was(5.8±0.4)min.The mean tissue weight of enucleation was(47.9±5.6)g,and the mean enucleation efficiency was(0.6±0.05)g/min.No intraoperative complications occurred.On the first day after surgery,the mean hemoglobin decreased(6.3±1.1)g/dL.The mean catheterization time was(4.4±0.3)days.Postoperative three-month follow-up results showed the mean Q_(max) was(22.6±0.8)mL/s,the mean IPSS score was(4.3±0.8),and the mean QoL score was(0.9±0.2).One patient had recurrent urinary tract infection,and all the 3 patients who had sexual life had reverse ejaculation.No long-term urinary incontinence,urethral stricture or other complications were found.Conclusion SPThuFLEP is safe and effective in treating BPH.Different parameter settings have little influence on the efficiency and effect of SPThuFLEP.
作者
王劲夫
逄城
袁园
王建龙
刘明
WANG Jinfu;PANG Cheng;YUAN Yuan;WANG Jianlong;LIU Ming(Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing,100730,China)
出处
《临床泌尿外科杂志》
CAS
2023年第5期338-341,346,共5页
Journal of Clinical Urology
基金
十四五国家重点研发计划(No:2022YFC3602900)。
关键词
良性前列腺增生
脉冲式光纤铥激光
前列腺剜除术
benign prostatic hyperplasia
pulsed thulium fiber laser
enucleation of prostate
