1470 nm半导体激光汽化切割术在高危前列腺增生症治疗中的应用  

1470 nm diode laser for benign prostatic hyperplasia in high-risk patients

作　　者：徐炜[1] 张书贤[1] 周发友[1] 王允武[1] 彭伟[1] 章小毅[1] 沈亚军[1] 吴宜龙 郑久德 高攀[1] 

机构地区：[1]皖南医学院第二附属医院泌尿外科,安徽芜湖241000

出　　处：《皖南医学院学报》2017年第3期228-231,共4页Journal of Wannan Medical College

基　　金：皖南医学院重点科研项目培育基金(WK2016ZF10)

摘　　要：目的:探讨经尿道1470 nm半导体激光汽化切割术治疗高危前列腺增生症临床效果与安全性。方法:回顾性分析2016年1~10月在我院接受经尿道1470 nm半导体激光汽化切割术42例高危前列腺患者临床资料。所有患者均有明显进行性排尿困难,经泌尿系彩超、肛门指检、PSA、前列腺穿刺活检等明确前列腺增生诊断,排除前列腺癌。每位患者均合并1种或1种以上老年性基础疾病,如糖尿病、高血压、冠心病、肺气肿、脑梗死后遗症等。观察患者术中生命体征变化、出血情况、手术持续时间、术后膀胱冲洗时间、尿管保留时间、继发性出血以及手术前后红细胞、血红蛋白、红细胞压积、血清钾、钠变化情况,以评价手术安全性;术后2个月评估国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)与术前比较,以评价手术效果。结果:42例手术均顺利完成,术中患者生命体征平稳,平均手术时间(81.1±35.7)min,术中几乎无出血,术后膀胱冲洗时间(19.1±9.2)h,术后尿管平均保留时间(4.5±0.6)d,术后平均住院日(5.4±1.3)d,手术前后红细胞、血红蛋白、红细胞压积、血清钾、钠等无显著改变(P>0.05),随访2个月,IPSS、QOL、Qmax、PVR各指标较术前明显改善(P<0.05),无大出血、尿失禁、心肺功能衰竭及明显的尿路刺激症状等发生。结论:经尿道1470 nm半导体激光治疗高危前列腺增生具有安全性高、效果显著等优点,尤其适合高危前列腺患者。Objective：To assess the clinical efficacies and safety of transurethral vaporization for treatment of benign prostatic hyperplasia（BPH） using 1470 nm diode laser in patients with high risk.Methods： Retrospective analysis was performed in 42 cases of high risk BPH treated in our hospital by transurethral vaporization using 1470 nm diode laser between January and October of 2016.All patients had typical progressive dysuria,and the cancerous neoplasm was excluded by urinary ultrasonography,anal digital examination（DRE）,test of the prostate specific antigen（PSA） and prostatic biopsies.Each patient was concomitant with one or more basic senile diseases,including diabetes,hypertension,coronary heart disease,emphysema or sequel following cerebral infarction.The surgical safety was assessed by observing the intraoperative changes of vital signs,blood loss,surgical duration,time of postoperative bladder irrigation and urinary tube retention,secondary hemorrhage as well as the changes of red blood cell（RBC）,hemoglobin（Hb）,hematocrit（HCT） and serum potassium（K＋） and sodium（Na＋） levels before and after operation,and the surgical efficacies were evaluated three months after surgery using the international prostate symptom score（IPSS）,quality of life score（QOL）,maximum urinary flow rate（Qmax）,and postvoid residual urine volume（PVR）.Results： The operation was completed smoothly in all patients whose vital signs were stable.The operative time was（81.1±35.7） min,and the intraoperative blood loss was minor.Postoperative bladder irrigation was（19.1±9.2）h,and postoperative retention of the urinary tube was（4.5±0.6）d.Postoperative hospital stay was（5.4±1.3）d.The change of RBC,Hb,HCT,serum potassium（K＋） and sodium（Na＋） levels was not significant before and after operation（P〉 0.05）.Follow-up in two months following surgery indicated significant improvement in IPSS,QOL,Qmax and PVR（P〈0.05）.No severe complications were reported,including

关 键 词：前列腺增生 半导体激光 高危 

分 类 号：R699.8[医药卫生—泌尿科学]