直出式绿激光剜除结合汽化术治疗大体积良性前列腺增生的疗效及体会  

Effect and experience of transurethral front-firing greenlight laser enucleation and vaporization in the treatment of large-volume benign prostatic hyperplasia

作　　者：王振中[1] 赵啟群 朱清毅 WANG Zhenzhong;ZHAO Qiqun;ZHU Qingyi(Department of Urology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京医科大学第二附属医院泌尿外科,南京210000

出　　处：《中国性科学》2024年第5期35-39,共5页Chinese Journal of Human Sexuality

摘　　要：目的探讨直出式绿激光剜除结合汽化术(FFGreenLEVP)治疗大体积良性前列腺增生的安全性及有效性。方法回顾性分析2019年1月至2022年12月南京医科大学第二附属医院收治的52例大体积良性前列腺增生患者的临床资料(试验组),前列腺体积80~120 mL,平均(88.92±8.37)mL,均采取FFGreenLEVP治疗。记录并分析手术时间、术中损失血红蛋白量、术中及术后并发症、术后住院时间、术后膀胱冲洗时间、术前及术后2个月国际前列腺症状评分(IPSS)、生活质量指数(QoL)及最大尿流率(Qmax)。将上述指标与2015年5月至2017年10月收治的31例采用经尿道前列腺切除术(TURP)治疗的大体积良性前列腺增生患者的临床资料(对照组)进行比较。结果所有接受FFGreenLEVP治疗的患者均顺利完成手术。手术时间(83.10±10.67)min。术中损失血红蛋白量(10.41±1.20)g。术后膀胱冲洗时间(1.55±0.63)d。术后有6例出现暂时性尿失禁,其中4例拔管后3 d内基本恢复尿控,2例拔管后1周恢复尿控。术后2个月IPSS及QoL评分均显著低于术前,Qmax显著高于术前,差异具有统计学意义(P<0.01)。术后1个月,1例出现轻度尿道外口狭窄,采用尿道扩张后治愈。有46例随访至今无明显复发。与对照组比较,试验组手术时间、术后冲洗时间更短(P<0.01);两组术后2个月QoL评分、IPSS、Qmax比较,差异无统计学意义(P>0.05)。结论FFGreenLEVP治疗大体积良性前列腺增生患者安全有效,可以同时发挥绿激光切割和汽化的优势。Objective To explore the safety and efficacy of transurethral front-firing greenlight laser enucleation and vaporization(FFGreenLEVP)in the treatment of large-volume benign prostatic hyperplasia.Methods Clinical data of 52 patients(experimental group)with large-volume benign prostatic hyperplasia who received treatment at the Second Affiliated Hospital of Nanjing Medical University from January 2019 to December 2022 were retrospectively analyzed.The volume of prostate was 80-120 mL,average(88.92±8.37)mL,and FFGreenLEVP was used in treatment of all patients.Operation time,the intraoperative hemoglobin loss,the intraoperative and postoperative complications,the hospitalization time after operation,the postoperative bladder irrigation time,the international prostate symptom score(IPSS),quality of life index(QoL),and maximum urinary flow rate(Qmax)of before and two months after surgery were recorded and analyzed.The above indicators were compared with the clinical data of 31 patients(control group)with large-volume prostatic hyperplasia treated with transurethral resection of the prostate(TURP)from May 2015 to October 2017.Results All the patients treated with FFGreenLEVP successfully completed the surgery.The operation time was(83.10±10.67)min.The mean intraoperative hemoglobin loss was(10.41±1.20)g.The postoperative bladder irrigation time was(1.55±0.63)d.Temporary urinary incontinence was observed in 6 patients,of which 4 patients basically recovered urinary control within 3 days after removing the catheter and 2 patients recovered urinary control one week after removing the catheter.IPSS and QoL two months after operation were significantly lower than those before operation,Qmax was significantly higher than that before operation and the differences were statistically significant(P<0.01).One month after operation,1 patient developed mild external urethral stricture and was cured after urethral dilation.46 patients were followed up to date without significant recurrence.Compared with the control group,the oper

关 键 词：良性前列腺增生 大体积 直出式绿激光 前列腺剜除 前列腺汽化 经尿道前列腺切除术 

分 类 号：R697[医药卫生—泌尿科学]