经尿道接触式激光切除前列腺增生106例报告

采用美国ＳＬＴ接触式Ｎｄ：ＹＡＧ激光治疗仪经尿道治疗前列腺增生症１０６例。结果；有效手术时间为５０－１５０ｍｉｎ，平均８５ｍｉｎ，术中均未输血。均于术后６－２４ｈ停止冲洗膀胱，３－７ｄ拔除尿道内气囊导尿管，７－１４ｄ拔除膀胱造瘘管，出院。１０６例中９６例治愈，有效率为９０．５７％。     

经尿道自由激光束凝结与接触式激光前列腺气化切除术85例报告

采用Ｎｄ－ＹＡＧ接触式激光治疗仪行经尿道自由激光束凝结与接触式激光前列腺气化切除术８５例，经过２～６个月追踪随访，排尿通畅率达９６．４７％，临床疗效满意。认为：在同一硬性光纤上互换侧射自由激光束凝固探头和接触式气化探头，使用侧射凝固探头对侧叶照射，使前列腺组织苍白、坏死、气化、凝固、变硬，利于接触式气化探头的无血气化，加快了气化速度，增加了侧叶受激光治疗组织的体积，提高了远期疗效。提出了经尿道激光气化切除增生前列腺组织３０％以上的手术标准及气化切除前列腺重量的计算方法，为ＴＵＬＰ的手术标准提供了较可靠的量化依据。     

经尿道激光切除前列腺增生30例报告

我院从1995年2月以来应用Nd：YAG激光治疗仪治疗前列腺增生30例，现报告如下。1资料与方法1．1临床资料本组30例，年龄54～80岁，平均64岁。术前经B超测定前列腺重量为32．5～183．0g，平均71·ig。其中急性尿储留保留尿管7例，膀航造播1例，并发膀眈结石2例。25例并发有冠心病或肺气肿、慢性气管炎等疾病患者心电图均不正常。29例术前检查前列腺特异性抗原（PSA）和血前列腺酸性磷酸酶（PAP）均正常，另1例PSA高（20ng／ml），后经前列腺穿刺活俭病理检查证实为前列腺增生。1．2仪器设备采用中国科学院电子所生产的ZJWD－100型激光…     

经尿道接触式激光前列腺切除术145例

我们采用接触式激光前列腺切除术 (TULc- P)对 1 45例前列腺增生症 (BPH)患者进行治疗 ,疗效满意 ,现报道如下。1　资料与方法1 .1临床资料BPH患者 1 45例 ,平均年龄 6 5 .6岁。病史平均4.2年 ,前列腺体积平均 46 ml(2 9～ 76 ml)。中叶增生者 45例 (3 1 .0 % ) ,尿潴留者 3 9例 (2 6 .9% )。术前国际前列腺症状评分 (IPSS)平均 2 7.5分 ,其中重症 BPH1 2 2例 (2 0～ 3 5分 ) ,中度 BPH2 3例 (8～ 1 9分 ) ,生活质量评分 (QOL)平均 4.9分 ,剩余尿量(RUV)平均 1 5 6 .7ml,平均最大尿流率 (Qmax)与平均尿流率 (AFR)分别为 9.5 ml/…     

经尿道前列腺接触式激光切除术32例报告

报告高功率接触式经尿道前列腺切除32例。55W的功率,术中采用拖拉法、左右斜交叉切割法、定点旋转、渐进点切法等四种手法,术中、术后无出血,术野清晰,时间短,手术安全可靠,近期疗效满意。     

经尿道激光切除前列腺增生70例报告

目的评价经尿道激光切除前列腺增生的治疗效果.方法自1993年11月至1996年7月经尿道激光治疗前列腺增生70例.术后随访3～32月,平均18.4月.结果手术前后国际症状评分分别为27.1±2.4和5.7±3.5(P＜0.01),最大尿流率为7.8±2.6和15.4±2.1(P＜0.01).治疗效果满意.结论经尿道激光治疗前列腺增生症安全、可靠,尤其适用于高龄体弱或合并其他疾病的前列腺增生患者.     

经尿道激光治疗前列腺增生症

经尿道激光治疗前列腺增生症郭震华陈赐龄我院自１９９４年２月～１９９５年１０月应用ＤｏｒｎｉｅｒＭｅｄｉｌａｓＦｉｂｅｒｔｏｍ６０４０型激光治疗机，采用腺体组织间热疗（ＩＴＴ）治疗ＢＰＨ３５例，ＩＴＴ加腺体汽化切割联合治疗６８例。两种治疗方法相比，联合...     

接触式激光经尿道前列腺切除术：附324例报告

从１９９３年１２月至１９９５年７月应用ＳＬＴ接触式Ｎｄ：ＹＡＧ激光经尿道治疗良性前列腺增生症３２４例。获得随访２８４例，１～６个月９２例，７～２０个月１９２例，总有效率为８９．５％。本法是激光经光导传输系统至蓝宝石探头，直接接触前列腺腺体组织，产生凝固，气化，达到切割的效应，具有操作简便、精确。安全，并发症少和无需输血等优点。     

KTP／YAG激光经尿道前列腺切除术

总结采用ＫＴＰ／ＹＡＧ激光经尿道前列腺切除术５６例的经验。通过手术前后测剩余尿、尿流率的改变及经直肠Ｂ超观察前列腺残腔的变化，术后随访１３～２４１天，有效率达１００％。结果表明ＫＴＰ／ＹＡＧ激光经尿道前列腺切除术具有安全、疗效高、痛苦小、并发症少和恢复快等优点。     

Transurethral Nd:YAG laser prostatectomy with a laterally firing fiber: Local effects on tissue associated with erectile dysfunction

Background and Objectives: Transurethral laser prostatectomy is anticipated to become a recognized alternative to conventional transurethral resection of the prostate. However, the effects of this procedure on the nerves of the pelvic plexus and erectile dysfunction remain unaddressed. The objective of this study was to evaluate the effects of laser energy on extent of prostatic damage as well as injury to periprostatic cavernosal nerves and erectile dysfunction in a canine model. Study Design/Materials and Methods: Six adult male mongrel dogs underwent transurethral laser prostatectomy at 30 (n = 3) and 40 (n = 3) watt power settings. Total laser energy delivered varied between 6,000 and 13,800 joules. Erectile function was evaluated by pelvic nerve stimulation at 2, 4, and 8 weeks. Animals were then sacrificed to assess histopathology of the prostate at each time point. Results: Histopathologic changes were noted in the prostate in a dose-dependent manner and did not vary with different laser power settings. In dogs that received ?10,000 J, substantial prostate ablation confined within the capsule was achieved in every prostate gland. Adequate erectile responses were noted in five of six animals; all received < 10,000 J. In one animal that received a total dose of 13,800 J, an erectile response was not obtained, and histology revealed both prostatic capsule perforation in close proximity to the cavernous nerves and thermal neural damage. Conclusions: We conclude that cavernous nerve damage may result from excessive doses of laser energy during transurethral laser treatment of the prostate gland. In canines, the upper limit for periprostatic injury is between 10 and 14,000 joules. © 1995 Wiley-Liss, Inc.     

U100双频双脉冲激光治疗输尿管结石(附260例报告)

目的:探讨U100双频双脉冲掺钕钇铝石榴石(Nd:YAG)激光(FREDDY技术)治疗输尿管结石的临床疗效.方法:应用U100双频双脉冲Nd:YAG激光经内腔镜治疗输尿管结石260例,其中结石位于上段58例,中段157例,下段45例,其中67例伴有BPH,术前行ESWL者61例.结果:输尿管结石碎石成功率为96.5%(251/260),其中上段结石成功率为93.1%(54/58),中段成功率为97.4%(153/157),下段成功率为97.8%(44/45),三组结果比较差异无统计学意义(P＞0.05).平均手术时间25(7～45)min,平均激光工作时间(5.5±3.5)min,平均12(2～21)天排净结石,术后平均住院2.5(1～6)天.43.1%(112/260)的患者术后均有不同程度的肉眼血尿,对症处理后2～4天消失.无输尿管穿孔、撕裂、感染、脓肾等并发症.结论:FREDDY激光碎石手术时间短,组织损伤小,术后并发症少,是一种安全、高效的腔内泌尿外科碎石方法.     

Nd: YAG laser iridectomies: 100 consecutive cases

We reviewed the patient charts of our first 100 consecutive Nd:YAG laser iridectomies. Our success rate (99%) is the same as that reported by others. Iris bleeding was not problematic. We did find that relative pupillary block may still be present with a patent but very small Nd:YAG iridectomy; that transillumination is not an adequate criterion for assessing patency; and that a Nd:YAG laser iridectomy, probably in part because of its small size, frequently closes with chronic inflammation.     

经尿道接触式激光前列腺切除术

采用Ｎｄ－ＹＡＧ接触式激光仪行经尿道前列腺切除术（ＴＵＬｃ－Ｐ）７６例。９０．６％的患者术后疗效满意，排尿恢复正常者６１．０％，明显改善者２９．６％。术前有剩余尿（３５例）及尿潴留、留置导尿（１１例）的患者，术后１个月４３例恢复正常，仅３例有≤１５ｍｌ剩余尿。认为ＴＵＬｃ－Ｐ操作易掌握，安全，见效快，疗效肯定，对患者打击小。讨论了ＴＵＬｃ－Ｐ的适应证及其局限性。     

Ho-Nd:YAG组合激光前列腺切除术的探讨(附23例报告)

目的：进一步探索前列腺增生症的有效治疗。方法：应用Ｈｏ－Ｎｄ：ＹＡＧ（钬－钕：钇铝石榴石）组合激光机经尿道行前列腺切除术２３例。结果：术后均能自行排尿,仅有４例拔管后有轻微血尿,３天后消失,无手术并发症,近期效果令人满意。结论采用ＨＯ激光工除前列腺参获得与ＴＵＲＰ相似的疗效,且避免了ＴＵＲＰ相似的疗效。且避免了ＴＵ％Ｐ可能出现的并发症,具有操作易掌握、出血少、速度快、安全可靠等优点。     

Transurethral Canine Prostatectomy with the Nd:YAG Laser

Although laser energy in combination with conventional techniques has been used to ablate prostatic tissue in the dog, the use of the Nd:YAG laser alone to perform transurethral prostatectomies has not been feasible because of the difficulty of directing the laser energy into the prostate. In this study, a 600-μm quartz laser fiber with an attached gold-plated metal alloy reflector and a 1.06-μm Nd:YAG laser were used to perform transurethral laser prostatectomies in 10 mongrel dogs. Each dog received approximately 3600 J to each quadrant of the prostate. No signs of urinary incontinence were noted in any of the dogs postoperatively. Transurethral laser prostatectomies can be performed safely and effectively in the dog and can significantly decrease the incidence of postoperative urinary incontinence.     

钬激光治疗泌尿系结石(附155例报告)

目的：探讨钬激光治疗泌尿系结石的疗效。方法：总结利用Versa Pulse Select钬激光机经输尿管镜或膀胱镜治疗155例泌尿系结石患者的临床资料。结果：8例肾结石和7例膀胱结石均1次碎石成功;140例输尿管结石患者单次手术结石粉碎率为95．7％（134／140）,平均结石排净时间2．5周;平均手术时间25min、平均术后住院天数2．5d。术中无输尿管穿孔、撕裂等并发症。结论：钬激光治疗泌尿结石是一种有效的腔道泌尿外科碎石方法。     

Madigan前列腺切除术48例体会

对48例良性前列腺增生症（BPH）患者采用Madigan前列腺切除术进行治疗，术后随访12～52个月，平均30个月，疗效满意。对切除前列腺腺体时防止尿道损伤的操作要点进行讨论，认为此手术保留了尿道完整性，术后痛苦小，恢复快，并发症甚少，护理方便。