CAJ | 학술논문

目的探讨经尿道绿激光前列腺汽化术(PVP)治疗高龄高危良性前列腺增生症(BPH)的有效性及安全性.方法采用PVP治疗高龄高危BPH患者120例,观察平均手术时间、术中出血量、术后留置导尿管时间及手术并发症,记录并计算手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)及剩余尿量(RUV)等指标的差异.结果 120例患者均安全度过围术期,平均手术时间(52.6±5.8)min,术中出血量(20.4±9.5)ml,26例术后未留置导尿管,94例术后留置导尿管(24.5±15.9)h.IPSS及QOL分别由术前(28.5±3.8)分及(5.0±0.8)下降至(7.2±1.8)分及(1.5±0.6)分,Qmax由术前(5.2±3.1)ml/s增加至术后(15.2±4.3)ml/s,RUV由术前(118.6±15.2)m1下降至术后(16.5±4.6)ml,手术前后比较差异均有统计学意义(t值分别为8.28、8.19、7.52、9.41,P均＜0.05).结论 PVP是治疗BPH的一种独特、安全、有效的微创手术方法,手术操作简单、时间短、出血少、术后恢复快、并发症发生率及病死率低,尤其适用于高龄、伴发全身其他疾病的高危BPH患者.
목적 탐토경뇨도록격광전렬선기화술(PVP)치료고령고위량성전렬선증생증(BPH)적유효성급안전성.방법 채용PVP치료고령고위BPH환자120례,관찰평균수술시간、술중출혈량、술후류치도뇨관시간급수술병발증,기록병계산수술전후국제전렬선증상평분(IPSS)、생활질량평분(QOL)、최대뇨류솔(Qmax)급잉여뇨량(RUV)등지표적차이.결과 120례환자균안전도과위술기,평균수술시간(52.6±5.8)min,술중출혈량(20.4±9.5)ml,26례술후미류치도뇨관,94례술후류치도뇨관(24.5±15.9)h.IPSS급QOL분별유술전(28.5±3.8)분급(5.0±0.8)하강지(7.2±1.8)분급(1.5±0.6)분,Qmax유술전(5.2±3.1)ml/s증가지술후(15.2±4.3)ml/s,RUV유술전(118.6±15.2)m1하강지술후(16.5±4.6)ml,수술전후비교차이균유통계학의의(t치분별위8.28、8.19、7.52、9.41,P균＜0.05).결론 PVP시치료BPH적일충독특、안전、유효적미창수술방법,수술조작간단、시간단、출혈소、술후회복쾌、병발증발생솔급병사솔저,우기괄용우고령、반발전신기타질병적고위BPH환자.
Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate (PVP) in high-risk elder patients with benign prostatic hyperplasia (BPH). Methods A total of 120 high-risk elder patients with BPH underwent PVP procedure. The operating time, blood 1oss, indwelling catheterization and operation-related complications were monitored. The variables such as international prostate symptom score (IPSS), Quality of life (QOL) score, maximum urinary flow rate (Qmax) and residual urine volume (RUV) were recorded and compared pre- and post-operatively. Results All the 120 patients had a good peri-operative condition. The mean operating time was (52. 6 ± 5.8 )min, intraoperative blood loss was (20.4 ±9.5) ml. Among the 120 cases,26 did not received postoperative catheterization. In the other 94 cases received postoperative catheterization, the mean catheterization time was (24. 5 ± 15.9) hour. IPSS and QOL scores decreased from (28.5 ± 3.8) and (5.0 ± 0.8) preoperatively to (7.2 ± 1.8) and (1.5 ± 0.6)postoperatively. Qmax increased from ( 5.2 ± 3.1 ) ml/s to ( 15.2 ± 4.3 ) ml/s, and RUV decreased from ( 118.6 ± 15.2) ml to ( 16. 5 ± 4. 6) ml. There was significant difference for these parameters before and after the operation (Ps ＜ 0. 05 ). Conclusion The PVP is considered to be a safe, effective and minimally invasive procedure to treat BPHin high-risk elder patients. It is easy to manipulate, with advantages of shorter operating time,less blood loss, better tolerance and rapid recovery, especially for high-risk elder patients with BPH.