日间手术模式下180W绿激光前列腺汽化手术的初步体会  

Feasibility and safety of prostatic vaporization using 180W greenlight system in day surgery mode

作　　者：徐明[1] 付凯 李国槟 阳东荣[1] 孙传洋[1] 高洁[1] 陶伟[1] 朱进[1] 薛波新[1] Xu Ming;Fu Kai;Li Guobin;Yang Dongrong;Sun Chuanyang;Gao Jie;Tao Wei;Zhu Jin;Xue Boxin(Department of Urology,the Second Hospital Affilicated to Soochow Univercity,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院泌尿外科,215004

出　　处：《中华泌尿外科杂志》2018年第9期671-674,共4页Chinese Journal of Urology

摘　　要：目的探讨日间手术模式下180W绿激光治疗良性前列腺增生（BPH）的可行性和安全性。方法回顾性分析2017年1月至2018年1月收治的65例BPH患者的临床资料。年龄54-75岁。前列腺体积42-93ml。65例均采用180W绿激光系统行经尿道前列腺选择性光汽化术（PVP）治疗。根据患者住院流程分为13问组29例和住院组36例。13问组于门诊完成各项检查，24h内完成人院、手术、出院。日问组和住院组的前列腺体积分别为（67．3±15．9）ml和（70．4±16．1）ml，国际前列腺症状评分（IPSS）分别为（23．2±4．6）分和（23．9±4．5）分，最大尿流率（Qmax）分别为（6．7±2．5）ml／s和（6．8±2．8）ml／s，生活质量评分（QOL）分别为（4．7±0．9）分和（4．4±0．8）分、残余尿量分别为（133．9±81．3）ml和（105．8±76．3）ml，两组比较差异均无统计学意义（P〉0．01）。两组术前美国麻醉医师协会分级均为I-Ⅱ级。比较两组患者手术相关参数、术后留置尿管时间、术后住院时间、总住院费用、并发症发生情况，以及术后随访的IPSS、Qmax、QOL。结果本组65例手术均顺利完成。日间组和住院组的手术时问分别为（67．8±9．8）min和（70．9±12．8）min，激光发射时间分别为（49．8±8．3）min和（51．6±10．4）min，激光能量消耗分别为（295．7±112．6）kJ和（285．0±108．2）kJ，组间比较差异无统计学意义（P〉0．01）。日问组和住院组术后留置尿管时间分别为（14．6±2．0）h和（51．7±11．8）h，总住院费用分别为（23279±511）元和（27452±440）元，住院组术后住院时间为（3．0±0．8）d，两组比较差异有统计学意义（P〈0．01）。拔除尿管后，日间组发生尿潴留3例、血尿1例，住院组发生尿潴留2例，均予再次留置尿管治愈。术后随访3个月，日间组和住院组的IPSS分别为（12．4±3．3）分和（10．6±4�Objective To evaluate the feasibility and safety of 180W greenlight laser in the treatment of benign prostatic hyperplasia （BPH） in the day surgery mode. Methods A retrospective review included 65 patients with benign prostate hyperplasia who were treated with photoselective vaporization of the prostate （PVP） under 180W greenlight system from Jan 2017 to Jan 2018, was performed. The patients＇ age ranged from 54 to 75 years old and the prostatic volume ranged from 42 to 93 ml. All patients were classified into two groups [ day sugery group （ n = 29 ） and inpatient surgery group （ n = 36 ）]based on the wishes of patients. In day sugery group, the admission, operation and discharge were completed in 24 hours. The preoperative clinic parameters such as prostate volume, IPSS, Q QOL and PVR were recorded in the two groups. The prostatic volume in two groups was （67.3 ±15.9） ml and （70.4 ± 16.1 ） ml,respectively. The IPSS and QOL scores in two groups were （23.2e4.6 vs. 23.9±4.5） and （4.7 ±0.9 vs. 4.4± 0. 8） ,respectively. The Q and PVR in two groups were [ （6.7±2.5）ml/s vs. （6.8±2.8）ml/s] and [ （ 133.9 ± 81.3 ） ml vs. （ 105.8±76.3 ） ml, respectively. The time of catheterization and postoperative hospitalization, total cost, postoperative adverse events were recorded, too. All the clinic data of preoperation,intraoperation and postoperation were compared between two groups. Results The operations and follow-up were successfully executed in all patients. There were not statistical significance differences in preoperative parameters between the two groups （ P 〉 0. 05 ）. There were not statistical significance differences in operating time [ （67.8 ± 9.8） rain vs. （70.9 ± 12.8 ） rain ] ,laser time [ （49.8 ± 8.3 ） min vs.（51.6±10.4） min],energyused [（295.7±112.6） kJ vs. （285.0±108.2） kJ], between the two groups, too （ P 〉 0.05 ）. A significantly less mean catheter duration, hospital stay and hospital charges were observed in t

关 键 词：日间手术 良性前列腺增生 绿激光 前列腺选择性光汽化术 

分 类 号：R699.8[医药卫生—泌尿科学]