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目的 :分析钬激光剜除前列腺 (HoLEP)治疗前列腺增生症的临床疗效及并发症的防治。方法 :骶麻下使用美国科以人公司提供的大功率 1 0 0W钬激光器以及组织粉碎器对 1 50例前列腺增生患者进行经尿道前列腺剜除与前裂腺组织粉粹。结果 :一次手术成功 1 50例 ,手术时间 (2 0～ 78) 50min ,组织粉碎时间 (5～ 90 )2 8min ,获得前列腺组织重量为 (2 5～ 78) 58.8g(67.8% ) ,术后继发出血 3例 ,膀胱损伤 6例 ,尿道狭窄 4例 ,术后改开放手术 1例 ,无尿失禁 ,无闭孔神经反射 ,无水中毒。Qave9.3～ 3 .6ml/s(术前 ) ,1 8～ 2 9ml/s(术后 ) ,P<0 .0 1。I-PSS评分达优、良、中三组标准达 1 0 0 %。结论 :钬激光剜除前列腺疗效可靠 ,出血少 ,速度快 ,且可直达列腺外科包膜 ,术后呈TURP通道 ,特别适应高危BPH患者
Objective: To analyze the clinical efficacy and prevention and treatment of holmium laser in the treatment of benign prostatic hyperplasia (HoLEP). Methods: The patients undergoing sacral anesthesia were treated with high-power 100 W holmium laser provided by the American Medical Group Corporation and tissue disintegrator to transurethral resection of prostatic urethra and pre-cleft gland in 150 cases of prostatic hyperplasia. RESULTS: One hundred and fifty cases were successfully operated, the operation time (20 ~ 78) was 50min, the time of tissue crushing (5-90) was 28min, and the weight of prostate tissue was (58.8g, 58.8g, 67.8% Secondary bleeding in 3 cases, 6 cases of bladder injury, urethral stricture in 4 cases, open surgery in 1 case, no urinary incontinence, no obturator nerve reflex, no water poisoning. Qave9.3 ~ 3.6ml / s (preoperative), 18 ~ 29ml / s (postoperative), P <0. I-PSS score up to excellent, good, middle three standard up to 100%. Conclusion: The holmium laser has the advantages of reliable curative effect, less bleeding and faster bleeding, and can be directly implanted in the surgical field of the prostate. The postoperative TURP channel is especially suitable for high-risk BPH patients