经尿道1 470纳米半导体激光前列腺汽化术灌注液吸收的临床研究*

目的探索乙醇法监测经尿道1470 nm半导体激光前列腺汽化术中灌注液的吸收,评价该手术方式的安全性。方法分析2016年5月-2016年12月该科应用1470 nm半导体激光治疗前列腺增生患者32例,术中使用含有1.0%乙醇等渗盐水作为灌注液,监测患者呼出气乙醇浓度,计算灌注液吸收量。结果 32例手术均获成功,病理检查结果均为前列腺增生,手术时间平均(57.6±32.9)min,灌注液使用量平均(21.5±9.9)L,5例监测到灌注液吸收,平均吸收量(156.8±111.7)ml,术中患者呼吸、循环稳定,无乙醇中毒症状,无大出血、包膜穿孔、心肺功能衰竭发生。32例患者获随访3个月,患者排尿情况较术前明显改善,无尿道狭窄、尿失禁及二次出血发生。结论经尿道1470nm半导体激光前列腺汽化术中灌注液吸收发生率低,疗效确切,安全性高。

Absorption of irrigation fluid occurs during 1 470 nm diode laser vaporization of the prostate*

Abstract: Objective To investigate and evaluate the effects and safety of the operationabsorption of irrigation fluid occurs during 1 470 nm diode laser vaporization of the prostate by ethano. Methods We retrospectively analyzed the clinical data about 32 cases of BPH treated by 1 470 nm diode laser vaporization from May 2016 to December 2016 intraoperative use of isotonic saline contains 1.0% ethanol as perfusion fluid, monitor the patients’ breath ethanol concentration, calculation of perfusion fluid absorption. Results All the operations were successfully completed, the average operation time was (57.6 ± 32.9) min, the average perfusion fluid volume was (21.5 ± 9.9) L, only 5 cases detected perfusion fluid absorption, the average absorptive amount  was (156.8 ± 111.7) ml. During operation, all the patients with stable breathing, circulation, no alcohol poisoning symptoms, no bleeding, capsular perforation, cardiorespiratory failure occurred. All the 32 cases patients were followed up for 3 months, which revealed a significant improvement in dysuresia, no severe complications such as urethrostenosis, urinary incontinence, secondary hemorrhage were noted. Conclusion Fluid absorption little occurs during 1470 nm diode laser vaporization, it is safe and effective in treatment of benign prostatic hyperplasia.