半导体激光在使用抗凝药物前列腺增生患者中的疗效及安全性  

The efficacy and safety of diode Laser Technology on BPH patients with oral antiplatelet/anticoagulant therapy

作　　者：钱晓辉[1] 陈涛[1] 饶建明 黄河[1] Qian Xiao-hui;Chen Tao;Rao Jian-ming;Huang He(Department of Uology,The Fouth Hospital of Changsha,Changsha 410006,China)

机构地区：[1]长沙市第四医院泌尿外科,长沙410006

出　　处：《湖南师范大学学报（医学版）》2021年第1期139-143,共5页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:由于接受抗凝治疗的患者实施经尿道前列腺切除术(TURP)具有高出血风险。前列腺半导体激光切除术对患者是一种新的安全手术方法,本研究目的是探讨半导体激光治疗长期口服抗血小板/抗凝血剂(OAP/OAC)前列腺增生患者的安全性及有效性。方法:将本院2015年~2017年期间共105名接受半导体激光手术治疗的患者纳入本研究。患者分为2组,A组由48名患者接受低分子肝素(LMWH)桥接治疗,B组由57名患者继续接受OAP/OAC治疗。结果:A组患者术前和术后血红蛋白水平下降明显高于B组。在分析B组亚组时,华法林和噻氯匹定亚组的血红蛋白平均下降明显低于A组。国际前列腺症状评分在A组术后3,12,18和24个月显著低于B组。两组患者的生活质量评分、最大尿流率和排尿后残余尿量相似。A组中39例和B组42例患者术后未出现并发症。结论:在接受半导体激光手术治疗的高危患者使用OAP/OAC治疗是安全、有效的。Objective Diode laser vaporesection of the prostate is a new and safe approach for patients receiving anticoagulant therapy in whom transurethral resection of the prostate (TURP) may possess a high bleeding risk.We aimed to demonstrate the efficacy and safety of 980/1470nm diode laser in patients receiving oral antiplatelet/anticoagulant (OAP/OAC) therapy.Methods A total of 105 patients who underwent diode laser vaporesection of the prostate between 2015 and 2017 were enrolled in the study.Patients were divided into 2 groups.Group A consisted of 48 patients who underwent low molecular weight heparin (LMWH) bridging and group B consisted of 57 patients who were operated on while receiving OAP/OAC therapy.Results The drop in hemoglobin levels in the pre-and postoperative periods was significantly higher in group A than in group B.When subgroups were analyzed,the mean drop in hemoglobin was significantly lower in the warfarin and ticlopidine subgroups of group B than in group A.International Prostate Symptom Scores were significantly lower 3,12,18,and 24 months after surgery in group A than in group B.Quality of life scores,maximal flow rate values,and postmicturition residual urine volumes (ml) were similar between the 2 groups.A total of 39 and 42 patients in groups A and B,respectively,had no complications.Conclusions Our study showed the safety profile of continuing different OAP/OAC therapies in terms of bleeding problems in patients undergoing diode laser vaporesection.Diode laser vaporesection is a safe and effective surgical strategy for BPH patients.

关 键 词：抗凝血剂 低分子肝素 半导体激光 经尿道前列腺剜除 

分 类 号：R699[医药卫生—泌尿科学]