980nm第二代半导体红激光在前列腺增生治疗中的初步研究  

A preliminary study of second generation 980nm diode laser therapy for benign prostate hyperplasia

作　　者：张伟[1] 王禾[1] 保庭毅[1] 邱建新[1] 杨增悦[1] 张波[1] 马建军[1] 汪涌[1] 宋斌[1] 李欣[1] 雷永华[1] 赵娜[1] 付晓亮[1] 赵致广[1] 

机构地区：[1]第四军医大学唐都医院泌尿外科,陕西西安710038

出　　处：《现代泌尿外科杂志》2016年第4期263-266,共4页Journal of Modern Urology

摘　　要：目的评价980nm第二代半导体红激光治疗前列腺增生患者的有效性和安全性。方法回顾性分析我科2014年11月至2015年9月收治的前列腺增生患者的手术病例112例,其中980nm第二代半导体红激光前列腺剜除(DiLEP)手术组50例,经尿道等离子双极前列腺切除(PKRP)手术组62例。比较两组手术病例术前、术后3个月的国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)及残余尿量(PVR);观察2组患者的手术时间、手术前后血红蛋白变化、膀胱冲洗液体量、膀胱冲洗时间、留置尿管时间、手术并发症等相关指标。结果手术均获成功,两组患者术前IPSS评分、QOL评分、Qmax、PVR与术后第3个月指标相比均存在显著性差异(P<0.01)。组间比较发现,患者手术前后症状改善程度相似,差异无统计学意义(P>0.05)。DiLEP组和PKRP组在手术时间方面无明显差异(P>0.05),但在手术前后血红蛋白变化量、术后膀胱冲洗时间、冲洗液体量及术后留置尿管时间方面DiLEP组要优于PKRP组,两者有显著差异(P均<0.05)。两者术后并发症发生率相似,无统计学差异(P>0.05)。结论 980nm DiLEP治疗前列腺增生患者的手术效果与等离子双极电切系统相当,但在减少术中出血、缩短拔管时间方面有明显优势。980nm DiLEP是安全有效的手术方式,具有良好的前景。Objective To evaluate the efficacy and safety of second generation 980 nm diode laser therapy for benign prostate hyperplasia.Methods Clinical data of 112 surgical cases with hyperplasia of prostate treated during Nov.2014 and Sept.2015 were retrospectively reviewed.Of all cases,50 were treated with second generation980 nm diode laser enucleation of the prostate（DiLEP group）,and the other 62 receiving transurethral plasmakinetic resection of prostate（PKRP group）served as controls.International Prostate Symptom Score（IPSS）,quality of life（QOL）,preoperative maximal flow rate（Qmax）and post void residual urine volume（PVR）were compared before treatment and3 months after treatment.The mean operation time,hemoglobin reduction during operation,bladder irrigation fluid volume,bladder irrigating time,mean postoperative indwelling catheter time and incidence of complications were analyzed.Results Compared with the values 3 months after operation,the preoperative IPSS score,QOL score,Qmax and PVR had significantly been improved by either procedures（P0.01）.The degree of improvement in the two groups was similar（P0.05）.Neither group had significant difference in the mean operation time（P0.05）,but in hemoglobin reduction,bladder irrigation fluid volume,bladder irrigating time,and mean postoperative indwelling catheter time there were more advantages in the DiLEP group than in the PKRP group（P0.05）.There was no significant difference between the two groups in the incidence of complications（P0.05）.Conclusions The second generation 980 nm diode laser therapy has similar operation effect as plasmakinetic resection,but it has less risk of haemorrhage,and shorter catheter indwelling duration.Enucleation of the prostate using the second generation 980 nm diode laser is a safe,effective and promising method for the transurethral management of prostate.

关 键 词：前列腺增生 半导体红激光 经尿道前列腺剜除术 经尿道前列腺等离子双极电切术 外科手术 

分 类 号：R697.32[医药卫生—泌尿科学]