培训课件--绿激光泌尿手术中的应用.pptVIP

* This is a pre-op picture. * The Mean Peak Flow rate increased from 7.8 to 27 milliliters per second after 1 year and stayed on a high level through 5 years. * Post-Void Residual shows a dramatic and sustained decrease, too. * The results for the AUA symptom score show a long-lasting reduction in AUA symptom score. The score dropped from 22 pre-op down to 3.9 after one year and stayed stable over 5 years of follow-up. Short term results of this study with 3 and 6 months follow-up have also been published. 突破一：治疗安全，治疗全程由微电子控制记录并在电脑显示屏幕上显示。对患者体质要求低，可视治疗安全可靠。 　　突破二：选择性吸收，精确汽化，绿激光能被氧合血红蛋白大量吸收，对组织的汽化非常迅速和准确。 　　突破三：穿透深度浅，对组织无损伤：绿激光波长对前列腺组织的穿透深度只有1到2mm。 　　突破四：适用范围广，手术不分年龄段，20-90岁(高血脂、高血压、心脏病、糖尿病、心脏植入起搏器和支架等患者)都可治疗，对于前列腺大小、形状也几乎没有限制。 　　突破五：最佳止血效果，在可视系统下操作，视野清晰、开阔，将腺体组织汽化的同时，将血管凝住，无出血，无液体吸收问题，手术过程感觉舒适。 　　突破六：效果更佳，绿激光PVP与前列腺电切术相比，疗效更优，而无并发症。 * 　第五代美国绿激光PVP非常昂贵，一台价值就高达数百万元。目前全国总量也不到10台。 * 绿激光PVP治疗泌尿外科的现状及进展 绿激光技术原理 1 绿激光设备　 2 前列腺增生治疗现状及进展 3 绿激光治疗前列腺增生优势 4 能够很好的被氧合血红蛋白吸收 美国绿激光PVP治疗系统 ＰＶＰ绿激光 KTP激光 倍频激光 肉眼所见前列腺增生 低倍镜所见前列腺增生 高倍镜下所看到的前列腺增生图 高倍镜所见前列腺增生 高倍镜下所看到的前列腺增生图 前列腺增生的临床症状 PVP Laser Prostatectomy Vaporizes tissue Minimal bleeding No catheter post-op Uses a very high powered green laser and a thin, flexible fiber Fiber is inserted into the urethra through a cystoscope How does PVP work? n n Quickly and precisely vaporizes and removes the enlarged prostate tissue The green laser energy is hemostatic, so there is almost no bleeding How does PVP work? n n Pre Op Immediate Post Op 3 Months Post Op PVP Laser Removes Tissue Opens bladder neck Cavity similar to TURP Improvement in symptoms similar to TURP Less impotence than TURP, other morbidity similar The Mean Peak Flow Rate (ml/s) Malek et al., Mayo Clinic, Durability Study Green Light PVP Post Void Residual (ml.) Malek et al., Mayo Clinic, Durability Study Green Light PVP AUA Semptom Score Malek et al., Mayo Clinic, Durability Study Green Light PVP 无可比拟的手术优势 选择性吸收， 精确汽化 治疗安全 适用范围广， 手术不分年龄段 疗效更优， 而无并发症 穿透深度浅， 对组织无损伤 最