CAJ | 학술논문

目的探讨经尿道2μm激光治疗高龄高危患者良性前列腺增生（benign prostatic hyperplasia, BPH）的有效性和安全性。方法对86例75~95岁高龄高危BPH患者行经尿道2μm激光治疗术，观察手术时间、出血量、血清钠变化、手术并发症、国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）、残余尿量（PVR）等指标，术后随访6个月。结果86例患者激光治疗术均获成功，手术时间（42.8±32.2）min，留置尿管（3.2±2.4）d。手术前后血红蛋白分别为（132±19）g/L和（126±22）g/L，血清钠分别为（142．6±4．6）mmol/L和（141．7±3．9）mmol/L，手术前后两组指标比较，差异均无统计学意义（P>0．05）。术后随访，IPSS和QOL评分分别由术前的（21.6±5.2）分和（4.3±0.7）分降至（6.8±2.0）分和（2.0±0.2）分；Qmax由术前的（7.2±3.6）ml/s 升至（22.2±6.1）ml/s；残余尿量由术前的（160.6±26.6）ml降至（28.5±6．5）ml，手术前后各组指标比较，差异均有统计学意义（P﹤0.05）。结论经尿道2μm激光治疗高龄高危BPH患者安全、有效。
목적탐토경뇨도2μm격광치료고령고위환자량성전렬선증생（benign prostatic hyperplasia, BPH）적유효성화안전성。방법대86례75~95세고령고위BPH환자행경뇨도2μm격광치료술，관찰수술시간、출혈량、혈청납변화、수술병발증、국제전렬선증상평분（IPSS）、생활질량평분（QOL）、최대뇨류솔（Qmax）、잔여뇨량（PVR）등지표，술후수방6개월。결과86례환자격광치료술균획성공，수술시간（42.8±32.2）min，류치뇨관（3.2±2.4）d。수술전후혈홍단백분별위（132±19）g/L화（126±22）g/L，혈청납분별위（142．6±4．6）mmol/L화（141．7±3．9）mmol/L，수술전후량조지표비교，차이균무통계학의의（P>0．05）。술후수방，IPSS화QOL평분분별유술전적（21.6±5.2）분화（4.3±0.7）분강지（6.8±2.0）분화（2.0±0.2）분；Qmax유술전적（7.2±3.6）ml/s 승지（22.2±6.1）ml/s；잔여뇨량유술전적（160.6±26.6）ml강지（28.5±6．5）ml，수술전후각조지표비교，차이균유통계학의의（P﹤0.05）。결론경뇨도2μm격광치료고령고위BPH환자안전、유효。
Objective To evaluate the safety and efficacy of the 2 micron continuous-wave laser vaporesection of the prostate for the treatment of elderly patients with benign prostatic hyperplasia (BPH). Methods The 2 micron continuous-wave laser vaporesection was performed on 86 BPH patients with the average age of 75~95 years old. The operative duration, volume of blood loss,serum sodium level, indwelling catheterization duration and operative complications were observed.The variables such as IPSS, QOL, Qmax, PVR were recorded and calculated before and after operation.All cases were followed up for 6 months. Results The 2 micron continuous-wave laser vaporesection was successfully performed in all patients.The operative duration was (42.8 ±32.2)min, the indwelling catheterization time was (3.2 ±2.4)d. Hemoglobin decreased from preoperative (132 ±26)g/L to postoperative (128 ±21)g/L, serum sodium level decreased from preoperative (142.6±4.6)mmol/L to postoperative (141.7±3.9)mmol/L. IPSS and QOL scores decreased from preoperative (21.6±5.2) and (4.3±0.7)scores to postoperative (6.8±2.0) and (2.0±0.2)scores respectively. Qmax increased from (7.2 ±3.6)ml/s to (22.2 ±6.1)ml/s, PVR decreased from (160.6 ±26.6)ml to (28.5 ±6.5)ml. There were significant differences in above parameters between those before operation and after operation (P < 0.05). Conclusion The 2 micron continuous-wave laser is a safe, efficacious and minimally invasive procedure for the treatment of elderly patients with benign prostatic hyperplasia(BPH).