选择性绿激光前列腺汽化术治疗良性前列腺增生110例报告

目的探讨经尿道选择性绿激光前列腺汽化术（photoselective vaporization of the prostate，PVP）治疗良性前列腺增生（benign prostatic hyperplasia，BPH）的临床优势和疗效。方法2006年7月-2007年8月，对110例BPH应用选择性绿激光经尿道汽化增生前列腺组织，观察术中安全性，手术前后最大尿流率（Qmax）、国际前列腺症状评分（IPSS）。结果110例手术时间15～180min，（51．2±36．3）min。前列腺≥100g 23例中9例行电切辅助。89例膀胱冲洗15～48h，平均36h。术后6例未留置导尿管，96例留置导尿管〈72h，术前尿潴留较重患者8例留置尿管3～7d。住院时间4～9d，平均6d。术后3个月IPSS从术前（24．1±6．4）降至（5．3±2．9），Qmax从术前（4．9±2．7）ml／s增至（19．1±10．1）ml／s。无严重并发症。结论PVP治疗BPH手术过程安全，无严重并发症，尤其适合于高龄高危患者，效果满意。

Clinical Analysis of 110 Patients with BPH Undergone Photoselective Vaporization of the Prostate

Objective To discuss the efficacy of photoselective vaporization of the prostate （PVP） for patients with benign prostatic hyperplasia （ BPH）. Methods From July 2006 to August 2007, 110 patients with BPH received PVP in our hospital. The safety of the procedure, Pre- and postoperative Qmax, and IPSS of the cases were recorded and analyzed. Results The mean operation time was （51.2 ±36.3） minutes （ranged from 15 to 180）. In the patients, 23 cases had a prostate weighed ≥100 g, 9 of them received TURP during the procedure. 89 patients underwent bladder irrigation for 15 to 48 hours （mean, 36 hours）. After the operation, urinary catheter was left indwelling in all the patients except for 6 （ 〈 72 hours in 96 patients, and 3 to 7 days in 8） ,who had serious urinary retention. The patients were discharged from hospital in 4 to 9 days （mean, 6 days）. Three months after the treatments, the IPSS of the patients decreased from 24.1 ± 6.4 to 5.3 ± 2.9, and the Qmax increased from （4. 9 ± 2.7 ） ml/s to （19.1 ± 10.1 ） ml/s. No serious complication occurred in this series. Conclusions The PVP is safe and effective for BPH without serious complications. The procedure is especially suitable for elderly patients.