选择性绿激光汽化术治疗重度前列腺增生患者的临床分析

目的探讨应用选择性绿激光汽化术（PVP）治疗重度前列腺增生症患者的临床疗效。方法回顾性分析自2004年7月至2008年7月应用PVP治疗78例前列腺体积大于80ml的良性前列腺增生症患者的临床资料。观察患者手术时间、住院时间、保留导尿管时间、输血率、术前后国际前列腺症状评分（IPS8）、最大尿流率、前列腺体积的变化及并发症。结果所有手术均成功，无输血，未出现电切综合征。平均手术时间（81．4±7．6）min，平均留置尿管时间（3．5±1．3）d，术后早期急性尿潴留9例（11．5％），轻度尿路刺激症状21例（26．9％），尿路感染10例（12．8％）。术后1个月IPSS评分、最大尿流率（Qmax）及前列腺体积改变均有统计学意义（P〈0．01），39例随访时间10-48个月，永久性尿失禁1例，6例需再次手术治疗，无尿道狭窄并发症发生。结论PVP治疗重度良性前列腺增生方法安全可行，但术后早期并发症发生率较高，可作为经尿道前列腺电切术（TURP）的一种补充手术方法应用于高危患者。

Greenlight photoselective vaporization of the prostate for the treatment of enlarged benign prostatic hyperplasia

Objective To evaluate the efficacy of greenlight photoselective vaporization of the prostate （PVP） for the treatment of enlarged benign prostatic hyperplasia, Methods Retrospective analysis was performed in 78 benign prostrate hyperplasia patients undergoing the PVP treatment,whose prostate volume was more than 80ml. Operative data, hospitalization periods, catheter removal, international prostate symptom score （IPSS）, maximum flow rates （Qmax）, prostate volume and complications were recorded. Results The PVP was successfully performed on all the 78 patients, none of them received blood transfusion and TUR syndrome. The operative time was （81.4±7.6）min and the postoperative urinary catheter time was （3.5±1.3）d. The rate of acute urinary retention, irritation and infection were 11.5%, 26.9% and 12.8% respectively. A significant improvement was observed in Qmax, IpSS values and prostate volume at 1 month. 39 cases were followed up 10 to 48 months after treatment, one patient was urinary incontinence and 6 roses need reoperation. Conclusions Although PVP offers advantages in intraoperative safety, early complication was higher in PVP that limited it＇s use in patients with enlarged prostates larger than 80 ml.