180W XPS绿激光经尿道前列腺汽化术治疗良性前列腺增生的临床应用体会  

Photoselective vaporisation of the prostate:initial experience with 180W XPS greenlight laser for the treatment of benign prostatic hyperplasia

作　　者：曹万里 阴雷[1] 琚官群 汪存洲[1] 林健海 王志军[1] 任吉忠[1] 刘冰[1] 王林辉[1] CAO Wanli;YIN Lei;JU Guanqun;WANG Cunzhou;LIN Jianhai;WANG Zhijun;REN Jizhong;LIU Bing;WANG Linhui(Department of Urology, Changzheng Hospital, Second Military Medical University, Shang- hai, 200003, Chin)

机构地区：[1]第二军医大学附属长征医院泌尿外科,上海200003

出　　处：《临床泌尿外科杂志》2018年第4期265-268,共4页Journal of Clinical Urology

摘　　要：目的:介绍180W XPS绿激光前列腺汽化术的初步临床应用体会。方法:25例良性前列腺增生(BPH)患者于本院行180W XPS绿激光前列腺汽化术,评估术中患者血钠下降量、血红蛋白下降量、手术时间、留置导尿时间、术后住院时间;评估术中术后输血、再住院、稀释性低钠血症、尿路感染、排尿困难等术后并发症情况;比较术后1、3个月患者国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))变化情况。结果:25例患者手术顺利,无中转经尿道前列腺电切术或者开放手术的病例。患者平均年龄(65.9±9.5)岁,平均前列腺体积(60.5±23.3)ml,平均手术时间(70.0±9.0)min,患者血红蛋白无明显降低,术中、术后未输血,无稀释性低钠血症发生,术后尿路感染、再入院、排尿困难各发生1例。术后平均导尿管留置时间(2.0±0.9)d,术后平均住院时间(2.5±1.0)d。结论:180W XPS绿激光经尿道前列腺汽化术出血少、效率高,是一种值得推广的治疗BPH的微创技术。Objective：To introduce the preliminary experience of 180W XPS greenlight photovaporization of the prostate（PVP）in the treatment of benign prostate hyperplasia（BPH）.Method：Twenty-five patients suffering from BPH have taken the 180W XPS greenlight PVP surgeries in this clinical center.The decreasing of serum sodium concentrations and hemoglobin after PVP,the time of operation,indwelling catheter and hospital stay were recorded.The complications after operation were also recorded,such as blood transfusion,readmission,transurethral resection syndrome,urinary tract infection and dysuria.The International Prostate Symptoms Score（IPSS）,quality of life（QOL）and maximum flow rate（Q_（max）） were compared between before and after operation.Result：All PVP surgeries were completed successfully,with no intraoperative conversion to open surgery or TURP.The mean age was（65.9± 9.5）years old,with a mean prostate volume covering（60.5± 23.3）ml.There were no significant differences in values of serum sodium concentrations and hemoglobin between before and after PVP.The complication rates after operation were low.The mean IPSS and QOL decreased significantly after 1-3 months of follow-up period（P0.05）,and the mean Q_（max） improved obviously（P0.05）.The mean time of catheterization and hospitalization was（2.0±0.9）days and（2.5±1.0）days respectively.Conclusion：180 W XPS greenlight PVP is a safe and promising procedure,which is less bleeding and efficient in treatment of BPH.

关 键 词：良性前列腺增生 经尿道前列腺绿激光汽化术 180W绿激光 

分 类 号：R737.25[医药卫生—肿瘤]