高龄高危BPH患者应用120W绿激光和2μm激光治疗的效果比较

刘磊; 陈昆; 王春涛; 李慎谟; 陈涛; 葛永超

doi:10.13201/j.issn.1001-1420.2020.04.005

高龄高危BPH患者应用120W绿激光和2μm激光治疗的效果比较

- 1. 河南中医药大学附属郑州人民医院郑东院区泌尿外科(河南郑州, 450000);
- 2. 郑州市第三人民医院泌尿外科
基金项目:
2015年度河南省医学科技攻关计划项目(No:201504057)

详细信息

通讯作者: 葛永超,E-mail:yongchaogyc@163.com

中图分类号: R697

收稿日期: 2019-07-05

Comparison on curative effect between 120W green laser and 2 μm laser on elderly patients with high-risk BPH

- 1. Department of Urology, Zhengzhou People's Hospital Affiliated to Henan University of Traditional Chinese Medicine, Zhengzhou, 450000, China;
- 2. Department of Urology, Third People's Hospital of Zhengzhou

More Information

Corresponding author: GE Yongchao, E-mail: yongchaogyc@163.com

Received Date: 05 July 2019

摘要

摘要: 目的:对比分析120 W绿激光、2μm激光治疗高龄高危良性前列腺增生(BPH)患者的临床效果。方法:回顾性分析2016年5月~2019年1月本院泌尿外科收治的128例BPH患者(年龄70~89岁、合并至少1种重要器官或血管疾病)的临床资料,根据激光手术方法不同分为Ⅰ组(68例)和Ⅱ组(60例),Ⅰ组行经尿道选择性120 W绿激光前列腺汽化术,Ⅱ组行经尿道2μm激光汽化切除术。记录手术完成及并发症发生情况,术后3个月评估残余尿量(RUV)、最大尿流率(Q_max)、国际前列腺症状评分(IPSS)及生活质量综合评定问卷量表(GQOLI)-74评分改善效果。结果:除Ⅰ组手术时间明显较Ⅱ组长以外(P<0.05),两组失血量、膀胱冲洗时间、留置导尿时间及住院时间均接近,差异无统计学意义(P>0.05)。术后3个月内,Ⅰ组、Ⅱ组继发性出血、感染、暂时性尿失禁、膀胱痉挛、尿道狭窄及电切综合征(TURS)发生率均较低(<10%),且差异无统计学意义(P>0.05)。术后3个月两组RUV、Q_max、IPSS评分及GQOLI-74评分均较术前显著改善(P<0.05),其中Ⅱ组RUV、Q_max改善效果明显优于Ⅰ组(P<0.05),而IPSS评分、GQOLI-74评分改善差异无统计学意义(P>0.05)。结论:120 W绿激光、2μm激光治疗高龄高危BPH疗效均较为可观,可改善患者尿道功能、生活质量,且并发症少,但后者手术时间更短、尿道功能恢复更好。
- 120W绿激光 /
- 2μm激光 /
- 高龄 /
- 高危 /
- 良性前列腺增生
Abstract: Objective: To compare the clinical curative effect between 120 W green laser and 2μm laser on elderly patients with high-risk benign prostatic hyperplasia(BPH). Method: The clinical data of 128 BPH patients(aged 70-89 years old, at least one important organ or vascular disease) who were admitted to urinary surgery of the hospital from May 2016 to January 2019 were retrospectively analyzed. They were divided into group Ⅰ(68 cases) and group Ⅱ(60 cases) according to different laser surgical methods. Group Ⅰ underwent transurethral selective 120 W green laser prostate vaporization, while group Ⅱ underwent transurethral 2μm laser vaporization excision. Surgery completion and occurrence of complications were recorded. At 3 months after surgery, residual urine volume(RUV), maximum flow rate(Q_max), improvement in International Prostate Symptom Score(IPSS) and generic quality of life inventory(GQOLI)-74 were evaluated. Result: The operation time of group Ⅰ was significantly longer than that of group Ⅱ(P<0.05). There was no significant difference in blood loss, bladder irrigation time, indwelling catheterization time or hospitalization time between the two groups(P>0.05). Within 3 months after surgery, incidence of secondary hemorrhage, infection, temporary urinary incontinence, bladder spasm, urethral stricture and transurethral resection syndrome(TURS) in both groups were relatively low(<10%). There was no significant difference(P>0.05). At 3 months after surgery, RUV, Q_max, IPSS and GQOLI-74 in both groups were significantly improved(P<0.05). The improvement of RUV and Q_max in group Ⅱ were significantly better than those in group Ⅰ(P<0.05). However, there was no significant difference in improvement of IPSS or GQOLI-74 score(P>0.05).Conclusion: The curative effects of 120 W green laser and 2μm laser are both relatively significant on the elderly with high-risk BPH, for satisfactory urinary function and quality of life, and low incidence of complications were shown. However, operation time of the latter is shorter, and recovery of urinary function is better.
- 120 W green laser /
- 2 μm laser /
- elderly age /
- high risk /
- benign prostatic hyperplasia

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参考文献(16)

[1]	李拔森,王良.良性前列腺增生介入治疗的现状和进展[J].影像诊断与介入放射学,2017,26(3):230-235.
[2]	Jhanwar A,Sinha R,Bansal A,et al.Outcomes of transurethral resection and holmium laser enucleation in more than 60 g of prostate:A prospective randomized study[J].Urol Ann,2017,9(1):45-50.
[3]	董滢,卜小斌,许平,等.两种方法治疗高龄、高危BPH合并膀胱多发结石的疗效比较[J].微创泌尿外科杂志,2018,35(4):44-47.
[4]	Bosch JL,Hop WC,Kirkels W J,et al.The International Prostate Symptom Score in a community-based sample of men between 55 and 74 years of age:prevalence and correlation of symptoms with age,prostate volume,flow rate and residual urine volume[J].Br J Urol,2010,75(5):622-630.
[5]	李凌江,杨德森.生活质量综合评定问卷(GQOLI-74)心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:88-100.
[6]	许鹏,彭谋,粘烨琦,等.160 W高功率直出绿激光汽化术与等离子双极电切术治疗高龄高危良性前列腺增生疗效比较[J].中国医师杂志,2018,20(8):1 228-1 230.
[7]	张晓波,陈明泉,陈雄,等.激光汽化术与前列腺电切术治疗良性前列腺增生疗效的Meta分析[J].中国内镜杂志,2017,23(7):16-21.
[8]	章俊,王曦龙,史朝亮,等.1 470 nm半导体激光前列腺汽化剜除术治疗复杂性良性前列腺增生(附80例报告)[J].现代泌尿外科杂志,2017,22(3):173-175.
[9]	沈善林,徐忠华,刘殿成,等.经尿道高功率绿激光前列腺汽化术治疗高危良性前列腺增生症效果观察[J].山东医药,2017,57(6):96-98.
[10]	Cornu JN,Ahyai S,Bachmann A,et al.A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction:an update[J].Eur Urol,2015,67(6):1066-1096.
[11]	Nair SM,Pimentel MA,Gilling PJ.A Review of Laser Treatment for Symptomatic BPH(Benign Prostatic Hyperplasia)[J].Curr Urol Rep,2016,17(6):45-53.
[12]	Huet R,Vincendeau S,Sebe P,et al.Photoselective vaporization of the prostate with Greenlight laser XPS 180W,Green laser enucleation of the prostate and open prostatectomy for benign prostatic obstruction:A comparative analysis of perioperative and short term results[J].J Urol,2017,197(4):e514-e515.
[13]	盛海波,孙斌,邢继章,等.经尿道2μm激光前列腺剜剥联合等离子电切术治疗大体积良性前列腺增生的疗效观察[J].中华保健医学杂志,2018,20(4):318-320.
[14]	Jiang Q,Xia S.Two-micron(Thulium)Laser Prostatectomy:An Effective Methodsfor BPH Treatment[J].Curr Bladder Dysfunct Rep,2014,9(2):142-144.
[15]	王建龙,张耀光,金滨,等.高龄前列腺增生患者行经尿道2 μm激光气化切除术的疗效及安全性[J].中华全科医师杂志,2017,16(7):855-858.
[16]	高跃,朱进,阳东荣,等.120 W绿激光及2 μm激光治疗高龄高危前列腺增生患者的比较[J].中华男科学杂志,2017,23(11):1 047-1 050.