980/1470nm双波长半导体激光治疗前列腺增生的短期疗效分析  

Short-term Effect of 980/1470nm Diode Laser Technology on Benign Prostatic Hyperplasia

作　　者：叶茂飞 张正望[1] 方伟林[1] 张忠云[1] 钱伟庆[1] Ye Maofei Zhang Zhengwang Fang Weilin Zhang Zhongyun Qian Weiqing(Department of Urology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, P. R. Chin)

机构地区：[1]复旦大学附属华东医院泌尿外科,上海200040

出　　处：《老年医学与保健》2017年第3期175-177,共3页Geriatrics & Health Care

摘　　要：目的分析980/1470 nm双波长半导体激光治疗前列腺增生的短期疗效。方法纳入2014年6月-2015年3月期间于复旦大学附属华东医院行前列腺增生手术治疗的患者57例,其中应用980/1470 nm双波长半导体激光完成经尿道前列腺汽化切除术的患者34例,经尿道前列腺等离子双极电切术的患者23例。回顾性分析比较两组的各项指标,包括年龄、前列腺体积、组织切割效率、手术时间、术中出血量、术后灌洗液量、尿管留置时间、血红蛋白量下降以及手术前后的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿(PVR)。结果 57例患者手术均获成功。两组患者的年龄、前列腺体积、术前IPSS、Qmax、PVR等均无差异。激光组的组织切割效率为(43.2±5.7)g/h,手术时间(1.8±0.5)h,术中出血量(8.1±3.2)mL,术后灌洗液量(12.1±2.1)L,尿管留置时间(4.5±0.7)d,血红蛋白量下降(0.5±1.4)g/L,,术后3个月随访IPSS评分下降(14.7±3.2)分,Qmax提高(13.3±1.6)mL/s,PVR减少(68.1±11.4)mL。与电切组相比,激光组在术中出血量、术后灌洗液量以及血红蛋白量下降等方面有明显优势,而其他指标差异无统计学意义。结论 980/1470nm双波长半导体激光治疗前列腺增生的短期疗效与等离子电切相当,而安全性较后者更加良好,尤其适用于高龄、高危患者,但长期疗效有待进一步随访研究。Objective To analyze the short-term effect of 980/1470 nm diode laser technology on benign prostatic hyperplasia.Methods 57 patients for surgical treatment of prostatic hyperplasia hospitalized during the period from June,2014 to Mar.,2015 were enrolled in the study;980/1470 nm diode laser transuresthral vaporization was performed on 34 patients（laser group） while transurethral plasma kinetic prostatectomy on other 23 patients（TUPKP group）;a retrospective analysis was made to the data of the patients in the 2 groups,including age,prostate volume,the tissue cutting effect,length of operation time,bleeding volume in operation,fluid volume of postoperative perfusion,indwelling catheter time,the decrease of hemoglobin and the changes of IPSS,Qmax and PVR after operation.Results Operations in the 57 patients were successful;there existed no difference in age,prostate volume and preoperative IPSS,Qmax and PVR between the patients in the 2 groups;in laser group,the effective rate of tissue cutting was（43.2 ±5.7） g/h,the length of operation time（1.8 ±0.5） h,bleeding volume in operation（8.1 ±3.2） mL,fluid volume of postoperative perfusion（12.1 ±2.1） L,indwelling catheter time（4.5±0.7） d and the decrease of hemoglobin（0.5±1.4） g/L;follow-up 3 months after operation showed a decrease of（14.7±3.2） points in IPSS scores,of（68.1 ±11.4） mL in PVR but an increase of（13.3±1.6） ml/s in Qmax in laser group;the laser group was of an obvious superiority in bleeding volume in operation,fluid volume of postoperative perfusion and decrease of hemoglobin to TUPKP group;no statistical differences in other data were found between the 2 groups.Conclusions980/1470 nm diode laser transuresthral vaporization is of similar short-term effect to TUPKP in treating prostatic hyperplasia and it is even safer,especially for senile and high-risk patients;the long-term effect needs a further follow-up study.

关 键 词：前列腺增生 激光 980/1470nm 前列腺电切 疗效 

分 类 号：R699.8[医药卫生—泌尿科学]