160W绿激光治疗前列腺增生症临床研究

目的探讨160 W绿激光治疗前列腺增生的临床效果及安全性。方法前列腺增生患者68例,其中31例接受160 W选择性绿激光气化术（PVP）治疗,37例接受80 W PVP术治疗,比较两组患者的手术时间、术中出血量、术后留置导尿管时间、术后住院时间、手术前后国际前列腺症状评分（IPSS）、生活质量（QOL）评分、最大尿流率、残余尿量改善情况;手术前后血红蛋白及电解质变化;以及近期并发症。结果 160 W组的手术时间明显短于80 W组,差异有显著意义（P〈0.05）;两组患者术中出血量、术后置尿管时间及术后住院时间差异无显著意义。两组患者术后IPSS、QOL评分、最大尿流率、残余尿量均明显改善,同术前比较差异有显著意义（P〈0.05）;160 W组与80 W组的残余尿量改善幅度差异有显著意义。所有患者术后电解质及血红蛋白浓度同术前比较差异无显著意义。术后80 W组和160 W组分别有5例和6例患者出现尿道刺激症状。两组患者均未出现电切综合征、尿失禁、尿道狭窄、继发血尿、性功能障碍等并发症。结论 160 W绿激光治疗前列腺增生症具有良好的疗效和安全性,气化效率较80 W绿激光显著提高,可大大缩短手术时间。

Clinical Research on the Treatment of Benign Prostatic Hyperplasia with 160 W Green-light Laser Photoselective Vaporization of Prostate

Objective To evaluate the clinical efficacy and safety of 160 W green-light laser photoselective vaporization of prostate(PVP) in treating benign prostatic hyperplasia. Methods Altogether 68 patients of benign prostatic hyperplasia with operation indication were randomly divided into two groups: one consisting of 31 patients treated with 160 W green-light laser PVP,and the other 37 patients treated with 80 W green-light laser PVP.The operation duration,blood loss,catheter-indwelling time,postoperative hospitalization period were compared respectively between the two groups.In addition,the improvement of international prostate symptom score(IPSS),quality of life(QOL) score,maximum urinary flow rate,residual urinary volume,change of serum hemoglobin and electrolyte and early complications were compared between the two groups. Results The operation duration in the 160 W group was significantly shorter than that in the 80 W group(P<0.05),but there were not significant differences in blood loss,catheter-indwelling time,postoperative hospitalization period between the two groups.The IPSS,QOL,maximum urinary flow rate,residual urinary volume were remarkably improved in both groups after the operation(P<0.05),but the difference between the two groups in improvement level was not significant.In both groups,the postoperative change of serum hemoglobin and electrolyte was not significant.There were 5 and 6 patients with urethral irritation symptoms respectively in the 80 W group and 160 W group,and no significant difference was observed between the two groups.No TURP syndrome,urinary incontinence,urethral stricture,secondary hematuria,sexual dysfunction or other complications happened in two groups. Conclusions 160 W green-light laser PVP is a safe and effective method for the treatment of benign prostatic hyperplasia.Compared with 80 W green-light laser,the vaporization efficiency of 160 W green-light laser is higher.It can also save operation time greatly.