中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
2期
131-134
,共4页
邵晋凯%王毓斌%吕永安%李晓东
邵晉凱%王毓斌%呂永安%李曉東
소진개%왕육빈%려영안%리효동
前列腺增生%经尿道前列腺切除术%激光疗法
前列腺增生%經尿道前列腺切除術%激光療法
전렬선증생%경뇨도전렬선절제술%격광요법
Prostatic hyperplasia%Transurethral resection of prostate%Laser therapy
目的 比较120 W 2μm激光前列腺剜除术与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的安全性与手术疗效,评估120 W2 μm激光前列腺剜除术治疗BPH的临床应用价值.方法 自2010年1月至2011年1月共入组168例BPH患者,88例应用120 W2 μm激光前列腺剜除术治疗,80例行TURP治疗.记录2组患者的手术时间、血红蛋白降低指数、血钠降低指数、膀胱冲洗时间、留置尿管时间、住院时间和手术并发症等.评估术前、术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)等.结果 2μm激光前列腺剜除术组平均手术时间(63.2 ±21.6)min,稍长于TURP组[(59.4±18.6)min],但差异无统计学意义.2μm激光组无输血病例.2 μm激光组和TURP组术后平均留置尿管时间分别为(1.8±0.6)d和(3.5±2.6)d,差异有统计学意义(t=3.912,P＜0.05).术后随访3～12个月,2μm激光组IPSS、QOL、Qmax 及PVR分别为(6.1±2.0)分、(4.4±1.6)分、(18.8±4.8)ml/s和(21.6±16.5)ml,TUPP组分别为(6.3±2.4)分、(1.9±1.1)分、(18.4±4.2)m]/s和(23.2±14.6)ml,2组患者IPSS、QOL、Qmax及PVR较术前均明显改善(t=12.453～26.213,P＜0.01),但两组间比较差异无统计学意义.2μm激光组并发症较少.结论 120 W 2μm激光前列腺剜除术是一种治疗BPH安全有效的新方法,疗效与TURP相似,且具有出血少、安全性高、术后留置尿管时间及住院时间短、恢复快等优点.
目的 比較120 W 2μm激光前列腺剜除術與經尿道前列腺電切術(TURP)治療良性前列腺增生(BPH)的安全性與手術療效,評估120 W2 μm激光前列腺剜除術治療BPH的臨床應用價值.方法 自2010年1月至2011年1月共入組168例BPH患者,88例應用120 W2 μm激光前列腺剜除術治療,80例行TURP治療.記錄2組患者的手術時間、血紅蛋白降低指數、血鈉降低指數、膀胱遲洗時間、留置尿管時間、住院時間和手術併髮癥等.評估術前、術後國際前列腺癥狀評分(IPSS)、生活質量評分(QOL)、殘餘尿量(PVR)、最大尿流率(Qmax)等.結果 2μm激光前列腺剜除術組平均手術時間(63.2 ±21.6)min,稍長于TURP組[(59.4±18.6)min],但差異無統計學意義.2μm激光組無輸血病例.2 μm激光組和TURP組術後平均留置尿管時間分彆為(1.8±0.6)d和(3.5±2.6)d,差異有統計學意義(t=3.912,P＜0.05).術後隨訪3～12箇月,2μm激光組IPSS、QOL、Qmax 及PVR分彆為(6.1±2.0)分、(4.4±1.6)分、(18.8±4.8)ml/s和(21.6±16.5)ml,TUPP組分彆為(6.3±2.4)分、(1.9±1.1)分、(18.4±4.2)m]/s和(23.2±14.6)ml,2組患者IPSS、QOL、Qmax及PVR較術前均明顯改善(t=12.453～26.213,P＜0.01),但兩組間比較差異無統計學意義.2μm激光組併髮癥較少.結論 120 W 2μm激光前列腺剜除術是一種治療BPH安全有效的新方法,療效與TURP相似,且具有齣血少、安全性高、術後留置尿管時間及住院時間短、恢複快等優點.
목적 비교120 W 2μm격광전렬선완제술여경뇨도전렬선전절술(TURP)치료량성전렬선증생(BPH)적안전성여수술료효,평고120 W2 μm격광전렬선완제술치료BPH적림상응용개치.방법 자2010년1월지2011년1월공입조168례BPH환자,88례응용120 W2 μm격광전렬선완제술치료,80례행TURP치료.기록2조환자적수술시간、혈홍단백강저지수、혈납강저지수、방광충세시간、류치뇨관시간、주원시간화수술병발증등.평고술전、술후국제전렬선증상평분(IPSS)、생활질량평분(QOL)、잔여뇨량(PVR)、최대뇨류솔(Qmax)등.결과 2μm격광전렬선완제술조평균수술시간(63.2 ±21.6)min,초장우TURP조[(59.4±18.6)min],단차이무통계학의의.2μm격광조무수혈병례.2 μm격광조화TURP조술후평균류치뇨관시간분별위(1.8±0.6)d화(3.5±2.6)d,차이유통계학의의(t=3.912,P＜0.05).술후수방3～12개월,2μm격광조IPSS、QOL、Qmax 급PVR분별위(6.1±2.0)분、(4.4±1.6)분、(18.8±4.8)ml/s화(21.6±16.5)ml,TUPP조분별위(6.3±2.4)분、(1.9±1.1)분、(18.4±4.2)m]/s화(23.2±14.6)ml,2조환자IPSS、QOL、Qmax급PVR교술전균명현개선(t=12.453～26.213,P＜0.01),단량조간비교차이무통계학의의.2μm격광조병발증교소.결론 120 W 2μm격광전렬선완제술시일충치료BPH안전유효적신방법,료효여TURP상사,차구유출혈소、안전성고、술후류치뇨관시간급주원시간단、회복쾌등우점.
Objective To compare the safety and efficacy of RevoLix 120 W 2 μm continuous-wave (cw)laser enucleation of the prostate with transurethral resection of prostate(TURP)in patients with symptomatic benign prostatic hyperplasia(BPH).And to evaluate clinical value of 120 W 2 μm cw laser enucleation.Methods All 168 patients with BPH underwent 2 μm cw laser enucleation(n =88)or TURP (n =80)between January 2010 and January 2011.The operative time,drop in hemoglobin,drop in serum sodium,indwelling catheterization time and operative complications were recorded.International prostate symptom score(IPSS),quality of life(QOL),urinary peak flow rate(Qmax)and post-voiding residual urine(PVR)were also compared.Results The mean operative time was slightly longer in the 2 μm laser group((63.2 ±21.6)min)than the TURP group((59.4 ± 18.6)min)(P ＞0.05).Transfusions were not necessary in 2 μm laser group.Catheter indwelling time were(1.8 ± 0.6)days vs.(3.5 ± 2.6)days in 2 μm laser group than in TURP group(t =3.912,P ＜0.05).All cases were followed up for 3-12 months,the IPSS,QOL,Qmax and PVR were 6.1 ±2.0,4.4 ± 1.6,(18.8 ±4.8)ml/s and(21.6 ± 16.5)rnl in the 2 μm laser group,and were 6.3 ± 2.4,1.9 ± 1.1,(18.4 ±4.2)ml/s,(23.2 ± 14.6)ml in TURP group respectively.All the markers were improved significantly compared with that of preoperative in both groups(t =12.453-26.213,P ＜ 0.01),but no statistical differences could be found between the two groups.Perioperative complications were less in the 2 μm laser group.Conclusions The 120 W 2 μm cw laser enucleation is an novel excellent treatment for BPH as well as TURP,and has the advantage of significantly less blood loss,shorter hospitalization,shorter catheter indwelling time and rapid recovery after surgery.
