1．94μm铥激光“三叶五步剜除法”治疗良性前列腺增生

目的总结1．94μm铥激光“三叶五步剜除法”治疗良性前列腺增生(BPH)的技巧及疗效,并评估其安全性.方法2014年5月15日至2016年5月15日期间,我院应用经尿道1.94μm铥激光手术治疗305例BPH患者.患者平均年龄(70．3±17．8)岁,前列腺体积(71．8±24．3)ml (40~190 ml),国际前列腺症状评分(IPSS)(22．8±4．9)分,最大尿流率(Qmax)(7．2±2．8)ml/s,残余尿量(RUV)(97．3±18．4)ml,PSA值(2．9±1．6)ng/ml.手术方法采用“三叶五步剜除法”.结果305例患者均顺利完成手术.手术时间平均(57．2±25．9)min,导尿管留置时间2．7 d(1~4 d),术后3个月 Qmax (23．1±5．2)ml/s,IPSS评分(7．0±3．7)分,RUV (8．9±3．3)ml,与术前相比差异均有统计学意义(P＜0．05).无电切综合征、继发性大出血、尿道狭窄、排尿困难、远期尿失禁、尿潴留等并发症发生.无新发勃起功能障碍患者.术后组织学检查均诊断为 BPH.结论1．94μm铥激光“三叶五步剜除法”组织切除彻底,并发症少,安全性高,是一种较为理想的BP H 治疗方法.

Treatment of benign prostatic hyperplasia with 1 .94μm thulium laser by the method of three lobes five-step enucleation

Objective To summarize the technique and clinical effect of 1.94μm thulium laser treatment for benign prostatic hyperplasia (BPH)by the method of three lobes five-step enucleation. Methods During May 15,2014 to May 15 2016,305 BPH patients,aged 70.3±17.8,with a mean prostate volume of (71.8±24.3)ml (40-190 ml),average international prostate symptom score (IPSS)of 22.8±4.9,average maximum urinary flow (Qmax)of (7.2±2.8)ml/s,average residual urine volume (RUV)(97.3±18.4)ml,PSA (2.9±1.6)ng/ml,were treated by 1.94μm thulium la-ser in our hospital by the method of three lobes five-step enucleation. Results The mean operative time was (57.2±25.9)min,and the mean postoperative catheterization time was 2.7 d (1-4 d).Three month after the operation,the IPSS was 7.0±3.7,the Qmax was (23.1±5.2)ml/s and RUV was (8.9±3.3)ml,which showed significantly improvement than before (P<0.05).There were no com-plication of TURS,massive haemorrhage,urethral stricture,dysuria,urinary incontinence,urinary retention,newly erectile dysfunction and retrograde ej aculation. Conclusions The method of three lobes five-step enucleation with 1.94μm thulium laser is an ideal way for treatment of BPH,with the advantages of rapid and thorough resection,less complications and high safety.