120W和180W光选择性前列腺汽化术对于80g以上腺体的高危前列腺增生患者的疗效比较  

Efficacy of GreenLight 180W vs.120W laser systems in the treatment of high-risk benign prostate hyperplasia in elderly patients with prostate over 80g

作　　者：童臻[1] 迟辰斐 施安[1] 孙杰[1] 李东[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿科,上海201200

出　　处：《现代泌尿外科杂志》2017年第2期100-103,共4页Journal of Modern Urology

基　　金：上海交通大学医学院附属仁济医院临床科技创新培育基金(No.PYXJS16-014)

摘　　要：目的比较120W与180W经尿道光选择性前列腺汽化术(PVP)对于80g以上腺体的高龄、高危良性前列腺增生(BPH)患者的疗效。方法分别用120 W和180 W532nm的LBO倍频激光治疗80g以上腺体的高龄、高危的BPH患者各30例。患者均合并高血压、糖尿病或心功能Ⅱ级以上。比较两种术式的手术时间、术中失血量、并发症及近期疗效等指标。结果全部患者均安全度过围手术期,未出现严重并发症,未输血。120 W组患者年龄(79.89±6.11)岁与180 W组(80.29±4.82)岁无明显差异。120 W组术前前列腺体积为(109.51±18.99)g,180 W组为(107.44±7.43)g。手术过程中能量消耗两组间无明显差异(P>0.05)。180W组的平均手术时间明显少于120W组[(60.00±15.10)min vs.(77.33±32.26)min,P<0.05]。两组术后国际前列腺症状评分(IPSS)、生活质量评分(QoL)、残余尿量(PVR)及最大尿流率(Qmax)均明显改善(P<0.05),但两组间改善程度无明显差别(P>0.05)。留置导尿时间180 W明显短于120 W组[(13.43±1.81)h vs.(29.78±23.38)h,P<0.05]。结论120 W与180 W PVP术对于80g以上腺体的高龄、高危BPH患者均安全有效,但是180 W能够明显缩短手术时间和留置导尿时间。Objective To evaluate the clinical efficacy of GreenLight 180 watts system and120 watts system in the photoselective vaporization of the prostate（PVP）for elderly high-risk patients with benign prostatic hyperplasia（BPH）with prostate over 80 g.Methods We allocated 60 aged high-risk BPH patients to 2 groups to unclergo receive 120 W（n= 30）and180 W（n=30）PVP.All patients had at least one comorbidity：hypertension,diabetes mellitus,or NYHA Ⅱ.The operation time,blood loss,rate of postoperative complications and clinical outcomes were compared.Results All operations were successful,and no severe postoperative complications occurred.None of the patients required transfusion.There was no significant difference in age between the two groups[（79.89±6.11）vs.（80.29±4.82）years].The mean volume of prostate was（109.51±18.99）g in the 120 W group and（107.44±7.43）g in the 180 W group.The energy applied was similar in the two groups.The duration of operation and catheterization time of the 180-W group was significantly shorter than that of 120-W group,[（60.00±15.10）vs.（77.33±32.26）min,（13.43±1.81）vs.（29.78±23.38）h,P0.05].There were dramatic improvements in international prostate symptom score（IPSS）,quality of life score（QoL）,and maximuin flaow rate（Qmax）postvoid residual（PVR）umepost-void residual urine（P0.05）in both groups after the treatment,but no significant difference was observed between the two groups（P0.05）.Conclusion Both 120 W and 180 W systems provide safe and effective treatment for high-risk elderly BPH patients with prostate over 80 g.The 180 W system can significantly shorten the operation and catheterization time.

关 键 词：良性前列腺增生症(BPH) 光选择性前列腺汽化术(PVP) 高危BPH患者 120 W 180 W 

分 类 号：R699.6[医药卫生—泌尿科学]