经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生的临床体会

目的探讨经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生患者的安全性、有效性和远期并发症情况。方法回顾性研究2017年10月至2018年9月我院45例<30g小体积前列腺增生患者的临床资料,其中TURP组20例,1470 nm激光组25例。详细记录两组患者的临床资料、围手术期并发症和随访情况。结果45例患者手术均成功,术后平均随访时间12.6个月(9~16个月)。两组患者年龄、前列腺体积和IPSS、RUV、Qmax和QOL基线资料差异无统计学意义(P>0.05)。TURP组和1470 nm激光组患者术后3个月IPSS、RUV、Qmax和QOL均较术前改善(P<0.05),组间比较差异无统计学意义(P>0.05)。1470 nm激光组患者手术时间([48.6±13.6)min vs(56.8±11.7)min,P=0.038]、术后膀胱持续冲洗时间[(0.8±0.5)d vs(1.5±0.9)d,P=0.001]、导尿管留置时间([2.7±0.6)d vs(4.7±0.9)d,P<0.001]和住院时间([4.2±1.2)d vs(5.2±1.9)d,P=0.036]较TURP组患者明显缩短,术前术后血红蛋白浓度变化更小([5.5±2.4)g/L vs(11.6±2.7)g/L,P<0.01]。随访发现TURP组有2例出现尿道狭窄,1470 nm激光组无尿道狭窄病例发生。结论经尿道国产1470 nm激光汽化术治疗<30 g小体积前列腺增生安全有效,与传统TURP比较术中出血少,术后恢复时间更短,无尿道狭窄并发症发生,为BPH的个体化治疗提供了新的思路。

Transurethral domestic 1470 nm laser vaporization for the treatment of<30 g small-volume benign prostatic hyperplasia

Objective To investigate the safety,efficacy and long-term complications of transurethral domestic 1470 nm laser vaporization for the treatment of<30 g small-volume benign prostatic hyperplasia.Methods From October 2017 to September 2018,45 patients with<30 g small benign prostatic hyperplasia were retrospectively studied,including 20 patients in the TURP group and 25 patients in the 1470 nm laser group.The general clinical materials,perioperative complications and follow-up data of the two groups were recorded.Results 45 patients were operated successfully,the mean follow-up period was 12.6 months(9-16 months).There were no significant differences in age,prostate volume,IPSS,RUV,Qmax,and QOL baseline data between the two groups(P>0.05).The IPSS,RUV,Qmax and QOL of the two groups were improved compared with those before operation(P<0.05)and there was no significant difference between the two groups(P>0.05).The operation time of the 1470 nm laser group[(48.6±13.6)min vs(56.8±11.7)min,P=0.038],bladder irrigation duration[(0.8±0.5)d vs(1.5±0.9)d,P=0.001],catheter indwelling time[(2.7±0.6)d vs(4.7±0.9)d,P<0.001]and hospital stay[(4.2±1.2)d vs(5.2±1.9)d,P=0.036]were significantly shorter than those in the TURP group,with less hemoglobin changes before and after surgery[(5.5±2.4)g/L vs(11.6±2.7)g/L,P<0.01].Follow-up period revealed 2 cases of urethral stricture in the TURP group and no urethral stricture in the 1470 nm laser group.Conclusions Transurethral domestic 1470 nm laser vaporization is safe and effective for the treatment of<30 g smallvolume benign prostatic hyperplasia,intraoperative bleeding is less and recovery time is shorter when compared with TURP,and no urethral stricture complication was discovered during the follow-up period,which can provide an individualized treatment method for BPH.