选择性绿激光汽化术治疗良性前列腺增生的临床研究  

Photoselective vaporization of prostate for the treatment of benign prostatic hyperplasia

作　　者：洪宝发[1] 蔡伟[1] 符伟军[1] 杨勇[1] 王威[1] 陈耀富[1] 展洁[1] 张翠娥[1] 李炎唐[1] 崔胜堂 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《中华泌尿外科杂志》2005年第1期17-19,共3页Chinese Journal of Urology

摘　　要：目的　探讨经尿道选择性绿激光前列腺汽化术 (PVP)治疗良性前列腺增生 (BPH)的安全性和疗效。　方法　采用骶管麻醉 ,应用PVP治疗 16 1例BPH患者。观察术中骶麻效果、出血情况、手术时间、术后留置尿管时间、手术前后尿流率、国际前列腺症状评分 (IPSS)、生活质量评分 (QOL)及性功能等变化情况。　结果　除 1例改为硬膜外麻醉者外 ,余 16 0例均采用骶麻 ,手术顺利。手术时间15～ 2 10min ,平均 (44 .5± 2 2 .4 )min ,术中无输血病例。术后 2 1例未留置尿管 ;余 14 0例留置尿管时间2 4～ 72h ,平均 (34.4± 2 0 .8)h ,其中拔除尿管后出现 2例短暂排尿困难 ,2例继发性出血 ,无尿失禁等并发症发生。术后随访 3～ 6个月 ,最大尿流率由术前平均 (6 .5± 2 .4 )ml/s增加至术后 (19.8± 2 .1)ml/s ,IPSS及QOL与术前比较均有明显改善 ,差异有统计学意义 (P <0 .0 5 )。 4 9例术前保持性功能者 ,术后均保留良好性功能。　结论　PVP治疗BPH的操作简单、时间短、出血少 ,留置尿管时间短 ,术后性功能不受影响 ,尤其适合于高龄、高危患者。Objective To evaluate the safety and efficacy of photoselective vaporization of prostate (PVP) for the treatment of benign prostatic hyperplasia (BPH). Methods A total of 161 patients with symptomatic bladder outlet obstruction due to BPH underwent PVP via transurethral with Niagara PV TM system.The therapeutic results were assessed using following variables:the safety and efficacy of sacral anesthesia,blood loss,operative time,indwelling catheterization,mean Qmax,IPSS,QOL and the sexual function. Results The PVP was successfully performed on all the 161 patients with BPH.There were 160 patients under sacral anesthesia and only 1 under epidural anesthesia.The mean operative time was (44.5±22.4)min (range,15～210 min).All patients had minimal or no blood loss and no patients required blood transfusion.No postoperative catheterization was needed in 21 patients. The mean catheterization time was (34.4± 20.8 )h (range,24-72 h).Postoperatively 2 cases had transient dysuria and 2 experienced delayed hematuria.All cases were followed up for 3 to 6 months after treatment.The mean Qmax increased from (6.5± 2.4 )ml/s to (19.8±2.1)ml/s;mean IPSS and QOL decreased to 5.8±1.6 and 1.7±0.4,respectively,which showed significant improvement,compared with those before operation( P <0.05).The 49 cases with sexual function still remained potent postoperatively.All patients were satisfied with voiding outcome and had no postoperative incontinence. Conclusions The PVP is an excellent treatment modality for BPH.It can yield rapid, safe and effective relief for patients with obstructive BPH with minimal invasion,especially for those at advanced age or at high risk.

关 键 词：选择性绿激光汽化术 治疗 良性前列腺增生 安全性 骶管麻醉 生活质量评分 

分 类 号：R699[医药卫生—泌尿科学]