Transurethral prostate enucleation with 2 μm laser in the treatment of high-risk senior patients with benign prostatic hyperplasia
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摘要: 目的：探讨2 μm激光剜除技术治疗高龄高危BPH患者的疗效和安全性。方法：患者年龄80~95岁，平均（85±3）岁。超声检测前列腺体积44~160 ml，平均（74.5±19.4）ml。使用RevoLix 2 μm激光剜除治疗112例高龄高危BPH患者。观察术中出血情况、手术时间、术后尿管留置时间、手术并发症，记录手术前后IPSS、QOL、Qmax及PVR等指标差异。结果：112例患者均顺利完成手术。输血7例，手术前后血电解质及血红蛋白浓度差异无统计学意义（P>0.05）；平均手术时间（75±15）min；术后留置尿管5~7天。术后随访2~12个月，所有患者均未发生尿道狭窄，1例一过性尿失禁者1个月后恢复。IPSS评分及QOL评分分别从（27.3±5.4）和（4.8±0.2）降至（8.5±1.8）和（2.5±0.3）；Qmax由术前（6.8±0.5）ml/s升至（16.9±1.6）ml/s；PVR由术前（67.0±1.2）ml下降至术后（13.3±3.4）ml，手术前后比较均差异有统计学意义（P<0.01）。结论：2 μm激光剜除技术治疗高龄高危BPH安全有效。Abstract: Objective: To explore the efficacy and safety of 2 μm continuous wave laser vaporesection for the treatment of high-risk senior patients with benign prostatic hyperplasia(BPH).Methods: All 112 high-risk patients with BPH were treated by transurethral prostate enucleation with 2 μm laser under continuous epidural anesthesia or laryngeal mask anesthesia.The patients,average age was(85±3)years(80 to 95 years).The mean prostate volume was(74.5±19.4)ml(44 to 160 ml).The blood loss,operative time,indwelling catheterization and operative complications were observed.The variables such as IPSS,QOL,Qmax,PVR were recorded and calculated pre- and post- operatively.Results: All 112 patients successfully completed the transurethral prostate cnucleation.7 cases required blood transfusion,the average operative time was(75±15)min,the average postoperative catheterization time was 5-7 days.There was no recorded urethral stricture and no urinary incontinence except for one patient who recovered 1 mon after the operation with follow up time of 2-12 mon.The IPSS and QOI were reduced from(27.3±5.4)and(4.8±0.2)to 8.5±1.8 and(2.5±0.3)after the operation,The average Qmax was(6.8±0.5)ml/s before and increased to (16.9±1.6) ml/s and the average PVR was(67.0±1.2)ml/s before and reduced to(13.3±3.4)ml/s after the operation.There were significant differences between these parameters pre- and post- operation(P<0.01).Conclusions: Two μm continuous wave laser vaporesection of the prostate is a safe and effective procedure for high-risk senior patients with BPH.
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