RevoLix120瓦二微米激光前列腺汽化剜除术治疗高危良性前列腺增生

目的 探讨RevoLix 120 W 2μm激光前列腺汽化剜除术治疗高危良性前列腺增生(BPH)的安全性和有效性.方法 2010年1-12月,采用经尿道RevoLix 120 W 2μm激光前列腺汽化剜除术治疗高危BPH患者62例.观察手术时间、血红蛋白和血清钠变化、留置导尿管时间、手术并发症、国际前列腺症状评分(ⅡSS)、生活质量(QOL)评分、残余尿(PVR)、最大尿流率(Qmax)等指标.结果 手术均顺利完成.手术时间(52.6±28.2) min,无输血病例,术后均无心、脑、肝、肾等系统性疾病加重.术后留置导尿管时间3～6d.手术前后血红蛋白分别为(132±26) g/L和(128±21)g/L,血清钠分别为(142.4±4.9) mmol/L和(141.2±3.8) mmol/L,差异无统计学意义(P＞0.05).62例患者术后随访(7.2±3.5)个月,术后Qmax由术前的(7.6±4.2) ml/s增至(21.8±5.9) ml/s,PVR由术前的( 124.4±206.2) ml降至(21.5±26.5) ml,IPSS及QOL评分分别由术前的(20.4±6.8)、(4.5±0.9)分降至(6.2±2.2)、(2.0±0.3)分,差异有统计学意义(P＜0.01).结论 RevoLix 120W 2μm激光前列腺汽化剜除术治疗高危BPH安全有效,但应掌握手术技巧和加强围手术期处理.

The RevoLix 120 W 2 microm continuous-wave laser vaporesection of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia

Objective To evaluate the safety and efficacy of the RevoLix 120 W 2 microm continuous-wave laser vaporesection of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia(BPH).Methods From January to December 2010,62 high-risk patients with BPH underwent 2 microm continuous-wave laser vaporesection of the prostate.The operative time,decreased index in hemoglobin,decreased index in serum sodium,indwelling catheterization time,operative complications,international prostatic symptom scores ( IPSS ),quality of life( QOL ) scores,peak urinary flow rate (Qmax),and post voiding residual urine volume (PVR) were observed.Results All 62 patients recovered without incidents.Transfusions were not necessary in any patients.The operative time was (52.6 ± 28.2) min.The diseases of heart,brain,liver,kidnty were not worsen after operation.The indwelling catheterization time was 3-6 days.Hemoglobin decreased from preoperative ( 132 ± 26) g/L to postoperative ( 128 ± 21 ) g/L,serum sodium decreased from preoperative (142.4 ± 4.9) mmol/L to postoperative (141.2 ± 3.8) mmol/L.There were not significantly different between preoperative and postoperative results (P ＞ 0.05).All cases were followed up for (7.2 ±3.5) months,Qmax increased from (7.6 ±4.2) ml/s to (21.8 ±5.9) ml/s,PVR decreased from ( 124.4 ± 206.2) ml to (21.5 ± 26.5 ) ml.IPSS and QOL scores decreased from preoperative (20.4 ±6.8) and (4.5 ±0.9) scores to postoperative (6.2 ±2.2) and (2.0 ±0.3) scores.There were significantly different between preoperative and postoperative results(P ＜ 0.01 ).Conclusions The RevoLix 120 W 2 microm continuous-wave laser vaporesection of the prostate is safe and effective for the treatment of high-risk patients with BPH.But should improve surgical techniques in the operative procedure and strengthen individual perioperative management.