摘要
目的:评估1 470 nm半导体激光汽化术治疗良性前列腺增生(BPH)的安全性及疗效。方法:应用1 470 nm半导体激光汽化术治疗BPH患者156例,观察平均手术时间、激光发射时间、激光能量消耗、术中出血量、术后膀胱冲洗时间、术后留置导尿管时间、手术并发症,记录并计算手术前后血清钠、前列腺特异性抗原(PSA)、剩余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)及最大尿流率(Q_(max))等指标的差异。结果:1 56例手术均获得成功,无中转经尿道前列腺电切术及开放手术病例。手术时间(55.4±24.1)min,激光发射时间(34.7±14.3)min,激光能量消耗(249.4±118.2)kJ,术中出血量(26.8±13.6)ml,术后膀胱冲洗时间(11.9±5.3)h,术后留置导尿管时间(2.7±0.9)d。血清钠手术前后比较差异无统计学意义(P>0.05)。无严重并发症发生。术后3个月随访,PSA由术前(3.7±2.9)μg/L下降至术后(2.7±1.9)μg/L,PVR由术前(146.5±29.8)ml下降至术后(29.5±7.3)ml,IPSS及QOL评分由术前(23.7±7.2)及(4.2±0.7)分分别下降至(8.8±2.1)及(2.7±0.7)分,Q_(max)由术前(7.5±3.1)ml/s增加至术后(16.3±5.1)ml/s,手术前后比较均差异有统计学意义(P<0.05)。结论:1 470 nm半导体激光治疗仪治疗前列腺增生具有汽化效率高、并发症少、近期效果可靠、学习曲线短的优点,而且由于其汽化功率高,亦适合大体积前列腺,但其对患者勃起功能的影响及远期疗效仍需进一步研究和长期随访。
Objective:To evaluate the safety and effectiveness of 1470 nm laser vaporization of the prostate for the treatment of benign prostatic hyperplasia(BPH).Methods:A total of 156 patients with BPH were included in the present study.Operative time,laser emission time,laser energy consumption,blood loss,bladder irrigation time,catheter removal time and peri-operative complications were recorded.Prostate specific antigen(PSA),postvoid residual volume(PVR),International Prostatic Symptom score(IPSS),quality of life(QOL) score and maximum flow rates(Q_(max)) were measured preoperatively and 3 months postoperatively.Results:All of the 156 cases were operated on successfully,and none of them converted to TURP or open surgery.The mean operative time,laser emission time,laser energy consumption,blood loss,bladder irrigation time and catheter removal were(55.4 ±24.1) min,(34.7±14.3) min,(249.4±118.2) kJ,(26.8±13.6) mL,(11.9±5.3)h and(2.7±0.9) days respectively.No significant reductions were found in serum sodium levels(P>0.05).No severe complications were observed.Clinical outcomes(PSA,PVR,IPSS,QOL score and Q_(max)) showed immediate improvement from baseline(P<0.05).Conclusions:The results of our study show that 1 470 nm laser vaporization has the advantages of high vaporizing efficiency,low morbidity,and reliable recent effect.This procedure could be applied in a safe and effective manner for the treatment of BPH.
出处
《微创泌尿外科杂志》
2015年第1期20-22,共3页
Journal of Minimally Invasive Urology
