铥激光“剥橘”式切除术治疗良性前列腺增生症  

Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia

作　　者：夏术阶[1] 张沂南[1] 鲁军[1] 孙晓文[1] 张捷[1] 朱轶勇[1] 李维国[1] 

机构地区：[1]上海交通大学泌尿外科研究所

出　　处：《中华医学杂志》2005年第45期3225-3228,共4页National Medical Journal of China

摘　　要：目的探讨铥激光前列腺剥橘式切除术(TmLRPTT)治疗良性前列腺增生症(BPH)的手术方法并评估其安全性和有效性。方法应用50W2.01μm连续波铥激光对30例经国际前列腺症状评分(IPSS)、直肠指检(DRE)、经直肠超声(TRUS)、尿动力学和前列腺特异抗原(PSA)等检查而获得诊断的BPH患者行TmLRPTT。患者平均年龄74岁,B型超声估计前列腺平均体积58ml±13ml,术前平均IPSS19分,平均最大尿流率(Qmax8.0)ml/s。比较术前术后血Na+、K+、Cl-、血红蛋白(Hb)浓度及红细胞压积(HCT)的改变。随访患者术后1个月和3个月的IPSS和Qmax。结果手术时间平均56min,术中无明显出血,无输血病例,术前术后血Na+、K+、Cl-及HCT改变差异无统计学意义(P>0.05)。术后无需膀胱冲洗,导尿管留置时间1～3d。术后1个月平均Qmax为23.1ml/s,IPSS平均7.9分,术后3个月平均Qmax为24.7ml/s,IPSS平均7.1分。随访至术后3个月时,无新增勃起功能障碍(ED)及逆行射精病例。结论铥激光前列腺剥橘式切除术(TmLRPTT)治疗良性前列腺增生症安全有效。Objective To evaluate the safety and efficacy of thulium laser resection of prostatetangerine technique （TmLRP） in treatment of benign prostate hyperplasia （BPH）. Methods Thirty BPH patients, aged 74 （61 -83 ） , with a mean prostate volume of 58 ml, average international prostate symptom score （IPSS） of 19, and average maximum urinary flow （Qmax） of 8.0 ml/s underwent TmLRP using 50 watt, 2.01μm Tm laser. The values of hematocrit, serum sodium, potassium, and chlorine concentrations, hemoglobin, Qmax, and IPSS before and 1 and 3 months after TmLRP were compared. Results The mean operating time was 56 minutes. No significant bleeding was found during operation. Post-operative bladder irrigation was no necessary. The urethral catheter was indwelled for 1 -3 days post-operatively. There were not significant differences in values of hematocrit, serum sodium, potassium, and chlorine concentrations, and hemoglobin before and 1 - 3 months after the operation. One month after the operation, the Qmax, was 23. 1 ml/s and IPSS was 7.9, and 3 months after the operation the was 24.7 ml/s and the IPSS was 7.1. By the end of 3-month follow-up no new cases of impotence and retrograde ejaculation had been found. Conclusion TmLRP is a safe and efficient procedure in treatment of BPH.

关 键 词：激光 铥 前列腺增生 

分 类 号：R699[医药卫生—泌尿科学]