经尿道选择性绿激光汽化术治疗大体积良性前列腺增生症

【】目的总结80W绿激光汽化术治疗大体积良性前列腺增生症的技术及临床疗效。方法回顾性分析2007年9月-2009年11月完成经尿道80W绿激光汽化术治疗体积>100mL良性前列腺增生症患者围手术期及随访资料，包括术前前列腺体积、血红蛋白、国际前列腺症状评分（IPSS）、生活质量（QOL）评分，手术时间、汽化激光能量及术后血清钠、血红蛋白、术后留置尿管时间、IPSS、QOL评分、3个月后残余前列腺体积等。结果45例体积>100mL的良性前列腺增生症患者均在持续硬膜外麻醉下完成手术，无中转开放手术。术前前列腺体积（128.82±24.82）mL，血红蛋白（138.5±6.85）g/mL，IPSS评分27.10±2.88，QOL4.26±0.87，术前最大尿流率（6.53±3.76）mL/s，手术时间（141.00±30.19）min，汽化能量（36.14±11.64）MJ，术后3d血红蛋白（124.33±7.64）g/mL，术后留置尿管时间（101.55±20.55）h，术前与术后血清钠无明显变化，血红蛋白轻度下降，无需输血。3个月后残余前列腺体积（44.63±10.31）mL，IPSS评分11.58±2.52，QOL2.74±1.10。无尿道狭窄发生。结论经尿道80W绿激光汽化术治疗体积>100mL的良性前列腺增生症，具有良好的安全性和临床疗效，可作为此类患者的首选治疗之一。？【Abstract】ObjectiveToinvestigatetheefficacyandsafetyof80Watthigh-powerpotassium-titanyl-phosphate(KTP)photoselectivelaservaporizationoftheprostate(PVP)inpatientswithlarge-volumebenignprostatehyperplasia(>100mL).MethodsRetrospectiveanalysiswasperformedinpatientswithlarge-volumebenignprostatichyperplasia(>100mL),whoweretreatedwiththe80WattKTPtransurethralphotoselectivelaservaporizationoftheprostatefromSeptember2007toNovember2009.Thepreoperativeevaluationincludedprostatevolumebytransrectalultrasonicscanning,serumsodiumandserumhemoglobin,internationalprostatesymptomscore(IPSS)andqualityoflife(QOL)score.Theoperativetimeandvaporizationenergyandaverageindwellingcatheterizationtimewererecorded.Thepostoperativeserumsodium,serumhemoglobinaftertheoperationwerecomparedwiththosebeforetheoperation.After3months,theIPSS,QOLandresidualprostatevolumewereevaluated.ResultsForty-fivepatientsoftotally219patientswith>100mLprostateinvolumeweresuccessfullyoperatedundercontinuousepiduralanesthesia.Nonewaschangedtoopenoperation.Themeanpreoperativeprostatevolumewas(128.82±24.82)mL,themeanIPSSwas(27.10±2.88)andQOLwere(4.26±0.87).Themeanoperativetimewas(141.00±30.19)minutes.Themeanindwellingcatheterizationwas(102.17±19.50)hours.Theserumsodiumdidnotchange,whiletheserumhemoglobinlevelreducedmildlybutwithouttransfusion.After3month,themeanIPSSwas(11.58±2.52)andQOLwere(2.74±1.10)withresidualprostatevolumewas(44.63±10.31)mL.Nostricturewasobservedin〖LM〗thisgroup.ConclusionThetransurethralphotoselectivevaporizationoftheprostatewith80WattKTPlaserisasafeandeffectivetherapyforpatientswith>100mLprostateinvolumeinexperiencedPVPcenter.