经尿道选择性绿激光前列腺汽化术治疗高龄高危良性前列腺增生  

Evaluation of greenlight photoselective vaporization of prostate for the treatment of high-risk older patients with benign prostatic hyperplasia

作　　者：洪宝发[1] 符伟军[1] 蔡伟[1] 杨勇[1] 陈耀富[1] 展洁[1] 张翠娥[1] 

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》2006年第1期43-45,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)治疗高龄高危良性前列腺增生(BPH)的临床疗效及安全性。方法采用PVP治疗高龄高危BPH患者96例,观察平均手术时间、术中出血量、术后留置导尿管时间、手术并发症,记录并计算手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、剩余尿量及尿流率改变等指标的差异。结果96例均安全渡过围手术期,平均手术时间(24.8±6.5)m in,术中出血量(55.4±16.8)m l,术后留置尿管时间(1.6±0.7)d。IPSS及QOL评分由术前平均29.8±5.2及5.2±0.8分别下降至8.4±2.3及1.4±0.5,最大尿流率由术前(5.6±2.8)m l/s增加至术后(16.7±3.2)m l/s,剩余尿量由术前(168.0±22.5)m l下降至术后(24.6±5.8)m l,手术前后比较差异均有统计学意义(P<0.05)。术后近期疗效满意,无严重并发症。结论PVP是治疗高龄高危BPH的一种安全有效的微创手术,手术操作简单、时间短、出血少、术后恢复快。Objective To explore the efficacy and safety of greenlight photoseleetive vaporization of prostate （PVP） in high-risk older patients with benign prostatic hyperplasia （ BPH）. Methods A total of 96 high-risk older paticnts with BPH underwent PVP. The operative time, blood loss, indwelling catheterization and operative complications were observed. The variables such as IPSS, QOL, uroflowmetry, post-void residual urine volume （RUV） were recorded and calculated pro- and post-operatively. Results All the 96 patients safely got through perioperative period. The mean operative time was （24.8 ± 6.5） rain, intraoperarive blood loss was （ 55.4 ± 16.8 ） ml and postoperative indwelling catheterization was （ 1.6 ± 0.7 ） d. IPSS and QOL scores decreased form preoperative 29.8 ± 5.2 and 5.2 ± 0.8 to postoperative 8.4 ± 2.3 and 1.4 ± 0.5 ,respectively. Qmax increased from （5.6 ± 2.8 ） ml/s to （ 16.7 ± 3.2） ml/s, and RUV decreased from （ 168.0 ± 22.5 ） ml to （ 24.6 ± 5.81 ） ml. There were significant differences of these parameters between pie- and post-operation （ P 〈 0.05 ）. There were few complications and great patient＇s satisfaction with the short-term post-operative results. Conclusions The PVP is believed to be a safe,efficacious and minimally invasive procedure for older patients with high-risk BPH. It is easier to manipulate with advantages of shorter operative time, less blood loss, better tolerance and rapid recovery.

关 键 词：前列腺增生 高危 激光手术 

分 类 号：R699[医药卫生—泌尿科学]