2μm激光治疗长期口服抗凝药物良性前列腺增生临床观察.docVIP

2μm激光治疗长期口服抗凝药物良性前列腺增生临床观察 　　【摘要】目的：探讨2μm激光治疗长期口服抗凝药物良性前列腺增生患者的安全性及有效性。方法：对28例长期服用抗凝药物良性前列腺增生患者行经尿道前列腺2μm激光“刀削面”式汽化切除术。结果：手术时间为30～70min，平均时间（45±13）min；术后持续膀胱冲洗1～3d；留置尿管2～6d，膀胱造瘘管于拔出尿管后次日拔出；术后住院时间4～7d。术后随访3～6个月，术前与术后6个月平均IPSS分别为：（227±45）分、（68±35）分；QOL分别为：（52±04）分、（22±12）分；Qmax分别为：（64±15）mL/s、（188±32）mL/s，上述三项指标与术前比较，均有明显改善（P001）。结论：经过严格术前评估与恰当处理，2μm激光治疗长期口服抗凝药物良性前列腺增生患者安全有效。 　　【关键词】 2μm激光；前列腺增生；抗凝药物 　　2 μm laser in treating benign prostatic hyperplasia with long-term anticoagulative therapyWANG Zhongxing， LI Xuede， JIANG Zhiyong， He Qingxin， FAN Shenghai， BI Jinghua. Department of Andrology， No 181 Hospital of People’s Liberation Army of China， Guilin 541002， China 　　【Abstract】Objectives： To analyze the technical properties and safety of 2μm laser in the management of benign prostatic hyperplasia with long-term anticoagulative therapy. Methods： 28 patients with obstructive BPH and long-term anticoagulative therapy were treated transurethrally by the ‘sliced noodles-vaporesection’ technique using the Revolix70 W 2μm continuous laser. Results： The mean operation time was （45±13） （30-70）min； mean continuous bladder irrigation time was 1～3d； mean catheter time was 2～6d； mean hospitalization time was 4-7d. All patients were followed up for 3 to 6 months， and IPSS and QOL-Score improved from （22.7±45） and （5.2±04） to （6.8±3.5） and （2.2±1.2） respectively at six months after operation （P005）. Mean Qmax increased from （6.4±1.5）mL/s preoperatively to （18.2±3.2） mL/s 6 months postoperatively （P005）. Conclusion： With strict preoperative evaluation and management， 2μm continuous laser is safe and effective in treating benign prostatic hyperplasia with long-term anticoagulative therapy. 　　【Key words】2μm laser； Benign prostatic hyperplasia； Anticoagulative therapy 　　【中图分类号】R167【文献标志码】A 　　良性前列腺增生（benign prostatic hyperplasia，BPH）是老年男性常患疾病，因各种原因（如心脏支架植入、脑梗塞、冠心病等）患者需长期服用抗凝药物（阿司匹林、氯吡格雷等）。此年龄段患者也是心脑血管疾病高发阶段，患者需长期服用抗凝药物来预防疾病进展或术后需长期服用抗凝药物预防并发症发生，口服给药治疗或持续导尿，容易增加泌尿系感染风险，且对患者生活质