选择性绿激光汽化术治疗良性前列腺增生.docVIP

选择性绿激光汽化术治疗良性前列腺增生【摘要】 目的 探讨选择性绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)的方法和评估疗效。方法 采用持续硬膜外麻醉与鞍区麻醉，应用PVP治疗280例BPH患者。观察术中汽化情况、出血情况、手术时间、术后留置尿管时间、手术前、后尿流率与国际前列腺症状评分(IPSS)等变化情况。结果 246例采用硬膜外麻醉，34例为鞍区麻醉。手术顺利，手术时间28~190 min，平均(47．6±19．5)min，无输血患者。术后全部留置尿管；留置尿管时间12~120 h，平均(32．6±19．4)h，4例拔除尿管后出现短暂排尿困难，3例迟发性出血，无尿失禁等并发症发生。术后随访3~6个月，最大尿流率由术前平均(6．1±2．5)ml/s增加至术后(18．8±3．2)ml/s，IPSS与术前比较有显著改善，差异有统计学意义(P0．05)。结论 PVP治疗BPH的操作简单、时间短、出血少，留置尿管时间短，尤其适合于高龄、高危患者。 【关键词】 前列腺增生；前列腺选择性光汽化术；绿激光 Green light photos elective vaporization of prostate for the treatment of benign prostatic hyperplasia WANG Xi，XIONG Wei，LUO Jun，et al.Department of Urology，The First Peoples Hospital of Chongqing， Chongqing 400011，China 【Abstract】 Objective To evaluate the efficacy of green light photos elective vaporization of prostate(PVP)for the treatment of benign prostatic hyperplasia(BPH).Methods A total of 280 patients with BPH were treated by PVP under epidural anesthesia and saddle anesthesia.The therapeutic results were assessed using following variables:blood loss during operative，operative time，indwelling catheterization time，mean Qmax and IPSS.Results The PVP was successfully performed on all 280 patinets.The mean operation time was(47．6±19．5)min(range from 28 to 190 min).No patients required blood transfusion.All patients needed post．operative catheteration.The mean indwelling catheterization time was(32．6±19．4)h(ranged form 12 to 120 h).After operation，4 patients had transient dysusuria and 3 patients experienced delayed hematuria.All patients were followed up for 3 to 6 months after treatment.The mean Qmax increased from(6．1±2．5)ml/s to (18．8±3．2)ml/sand IPSS has significantly improved postoperatively.Conclusion PVP is a simple，safe and effective method for treatment of BPH with short treatment course，small amount of bleeding， and short indwelling catheterization time，especially for elderly and high risk patients. 【Key words】 Prostatic hyperplasia;Photos elective vaporization of prastate(PVP);Green ligh