CAJ | 학술논문

目的：探讨160 W直束绿激光剥离汽化术治疗良性前列腺增生症的手术方法并评估其安全性和有效性。方法采用中国瑞尔通公司生产的非接触式绿激光治疗系统进行PVP，额定输出汽化功率为160 W。通过改进，将侧出式光纤改为直出式光纤，采取逆行边剥离边汽化的手术方式，将前列腺完整剥离的同时又完全汽化。应用该激光对2012年1月至2013年1月共60例良性前列腺增生（BPH）患者行绿激光剥离汽化术，比较术前术后血Na＋、K＋、Cl－、血红蛋白（Hb）浓度及红细胞压积（HCT）的改变。随访患者术后1个月和3个月的残余尿量、最大尿流率（Qmax）、最大尿流率时逼尿肌压（Pdet／Qmax）等尿动力学指标以及国际前列腺症状评分（IPSS）、生活质量评分（QOLS）等主观感受评分。结果手术时间平均65分钟，术中无明显出血，无1例需要输血。术后3个月，最大尿流率由术前的（6．1±0．9）ml／s上升至（21．1±3．0）ml／s。国际前列腺症状评分由术前的（23．5±4．4）分下降至（8．2±1．3）分，生活质量评分由术前的（5．1±0．3）分下降至（1．8±0．2）分；这三项指标手术前后比较均有显著性差异。结论直束绿激光剥离汽化术治疗良性前列腺增生症安全有效。
목적：탐토160 W직속록격광박리기화술치료량성전렬선증생증적수술방법병평고기안전성화유효성。방법채용중국서이통공사생산적비접촉식록격광치료계통진행PVP，액정수출기화공솔위160 W。통과개진，장측출식광섬개위직출식광섬，채취역행변박리변기화적수술방식，장전렬선완정박리적동시우완전기화。응용해격광대2012년1월지2013년1월공60례량성전렬선증생（BPH）환자행록격광박리기화술，비교술전술후혈Na＋、K＋、Cl－、혈홍단백（Hb）농도급홍세포압적（HCT）적개변。수방환자술후1개월화3개월적잔여뇨량、최대뇨류솔（Qmax）、최대뇨류솔시핍뇨기압（Pdet／Qmax）등뇨동역학지표이급국제전렬선증상평분（IPSS）、생활질량평분（QOLS）등주관감수평분。결과수술시간평균65분종，술중무명현출혈，무1례수요수혈。술후3개월，최대뇨류솔유술전적（6．1±0．9）ml／s상승지（21．1±3．0）ml／s。국제전렬선증상평분유술전적（23．5±4．4）분하강지（8．2±1．3）분，생활질량평분유술전적（5．1±0．3）분하강지（1．8±0．2）분；저삼항지표수술전후비교균유현저성차이。결론직속록격광박리기화술치료량성전렬선증생증안전유효。
Objective To evaluate the effect of 160 W greenlight straight light beam laser enucleation of the prostate in the treatment of BPH. Methods Sixty BPH patients were underwent the 160W greenlight straight light beam laser enucleation. The values of serum sodium,potassium,and chlorine concentrations,hemoglobin,Qmax and IPSS before and 1 and 3 months after PVP were compared. Results The mean operating time was 65 mi-nutes. Post-operative bladder irrigation was no necessary. There were not significant differences in values of ser-um sodium,potassium,chlorine concentrations,and hemoglobin before and 1,3 months after the operation. At the first and third month postoperatively,IPSS,QOLS,Qmax were significantly improved compared with those pre-operatively (P<0 . 05 ). Conclusions 160 W greenlight straight light beam laser enucleation of the prostate is a safe and efficient procedure in treatment of BPH.