980/1470nm双波长半导体激光治疗前列腺增生的短期疗效分析

Short-term Effect of 980/1470nm Diode Laser Technology on Benign Prostatic Hyperplasia

中文关键词: 前列腺增生  激光  980/1470nm  前列腺电切  疗效

英文关键词: prostatic hyperplasia  laser  980/1470nm  transurethral plasma kinetic prostatectomy (TUPKP)  curative effect

中文摘要:

      目的 分析980/1470nm双波长半导体激光治疗前列腺增生的短期疗效.方法 纳入2014年6月-2015年3月期间于复旦大学附属华东医院行前列腺增生手术治疗的患者57例,其中应用980/1470 nm双波长半导体激光完成经尿道前列腺汽化切除术的患者34例,经尿道前列腺等离子双极电切术的患者23例.回顾性分析比较两组的各项指标,包括年龄、前列腺体积、组织切割效率、手术时间、术中出血量、术后灌洗液量、尿管留置时间、血红蛋白量下降以及手术前后的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿(PVR).结果 57例患者手术均获成功.两组患者的年龄、前列腺体积、术前IPSS、Qmax、PVR等均无差异.激光组的组织切割效率为(43.2 ±5.7) g/h,手术时间(1.8±0.5)h,术中出血量(8.1±3.2) mL,术后灌洗液量(12.1±2.1)L,尿管留置时间(4.5±0.7)d,血红蛋白量下降(0.5±1.4) g/L,术后3个月随访IPSS评分下降(14.7 ±3.2)分,Qmax提高(13.3±1.6) mL/s,PVR减少(68.1±11.4) mL.与电切组相比,激光组在术中出血量、术后灌洗液量以及血红蛋白量下降等方面有明显优势,而其他指标差异无统计学意义.结论 980/1470nm双波长半导体激光治疗前列腺增生的短期疗效与等离子电切相当,而安全性较后者更加良好,尤其适用于高龄、高危患者,但长期疗效有待进一步随访研究.

英文摘要:

      Objective To analyze the short-term effect of 980/1470nm diode laser technology on benign prostatic hyperplasia.Methods 57patientsforsurgicaltreatmentofprostatichyperplasiahospitalizedduringtheperiodfromJune,2014to Mar.,2015 were enrolled in the study;980/1470nm diode laser transuresthral vaporization was performed on 34 patients (laser group) while transurethral plasma kinetic prostatectomy on other 23 patients (TUPKP group);a retrospective analysis was made to the data of the patients in the 2 groups,including age,prostate volume,the tissue cutting effect,length of operation time,bleeding volume in operation,fluidvolumeofpostoperativeperfusion,indwelling catheter time,the decrease of hemoglobin and the changes of IPSS,Qmax and PVR after operation.Results Operations in the 57 patients were successful;there existed no difference in age,prostate volume and preoperative IPSS,Qmax and PVR between the patients in the 2 groups;in laser group,the effective rate of tissue cutting was (43.2 ±5.7) g/h,the length of operation time (1.8±0.5) h,bleeding volume in operation (8.1±3.2) mL,fluid volume of postoperative perfusion (12.1±2.1) L,indwelling catheter time (4.5 ±0.7) d and the decrease of hemoglobin (0.5 ± 1.4) g/L;follow-up 3 months after operation showed a decrease of (14.7±3.2) points in IPSS scores,of (68.1 ± 11.4) mL in PVR but an increase of (13.3 ± 1.6) ml/s in Qmax in laser group;the laser group was of an obvious superiority in bleeding volume in operation,fluid volume of postoperative perfusion and decrease of hemoglobin to TUPKP group;no statistical differences in other data were found between the 2 groups.Conclusions 980/1470nm diode laser transuresthral vaporization is of similar short-term effect to TUPKP in treating prostatic hyperplasia and it is even safer,especially for senile and high-risk patients;the long-term effect needs a further follow-up study.