2 μm激光汽化剜除前列腺增生的疗效和安全性分析

【摘要】 目的 分析应用 2 μm激光汽化治疗前列腺增生的效果及安全性。 方法 用经尿道 2 μm激光前列腺汽化剜除术（ThuVEP组）、普通电切设备经尿道前列腺剜除术（TUEP组）治疗前列腺增生症（BPH）患者 145 例。 观察并比较2组术中出血情况、冲洗液量、手术时间、术后膀胱冲洗时间、术后留置尿管时间、手术前后国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）、残余尿（RUV）及并发症等。 结果 2组患者年龄， 术前病程、前列腺质量、IPSS 评分、QOL评分、Qmax及 RUV 比较差异无统计学意义。 2组手术均获得成功。 ThuVEP组术中出血、术后冲洗时间、术后保留尿管时间等较 TUEP组减少（P＜ 0.05）， 且无术后并发症， TUEP术后并发症 5 例。 术后随访3～ 12个月 ， 2组患者IPSS、QOL、Qmax、RUV较术前明显改善（P＜ 0.01）， 但组间比较差异无统计学意义。 结论 经尿道 2 μm 激光汽化治疗前列腺增生症较传统 TUEP 更加安全有效， 能明显改善前列腺增生患者的排尿症状及生活质量， 且减少并发症的发生。

Relation of Isolated Systolic High-Normal Blood Pressure and Coronary Heart Disease in Middle-Aged and Elderly Persons

Objective To compare the efficiency of tranexamic acid single dose intraarticular injection and autologous transfusion drain on the blood loss post total knee arthroplasty (TKA). Methods 124 patients (124 knees) with varus knee osteoarthritis performed TKA were retrospectively analyzed, 24 males and 100 females, the mean age was 65.03 years. Due to the blood loss control methods, two groups were divided as TXA application group (test group, n = 49) and autologous transfusion drain group (control group, n =75). The blood loss and blood transfusion characters were analyzed. Results The allogeneic blood transfusion ratio 7 days post TKA surgery was 10.20% (5/49) in the test group and 17.33% (13/75) in the control group group (P＞0.05). The RBC, Hb, HCT all had statistics difference according to test period, between groups and effects of interaction in the two groups(P＜0.05). Significant difference was found when the RBC, Hb and HCT were compared at the 1,3,7 day post TKA between the two groups (P＜0.05), while the total blood loss post TKA showed no statistic difference (P＞0.05). Conclusion Compared with autologous transfusion drain, single dose intraarticular injection of tranexamic acid 500 mg can significantly improve the levels of RBC, Hb and HCT at the day 1, 3 and 7 after TKA. However, the blood transfusion ratio, total blood loss and Hb decline in 7 days post TKA showed no significant difference in the two groups.