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目的探讨选择性绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)的方法和评估疗效。方法采用持续硬膜外麻醉与鞍区麻醉,应用PVP治疗280例BPH患者。观察术中汽化情况、出血情况、手术时间、术后留置尿管时间、手术前、后尿流率与国际前列腺症状评分(IPSS)等变化情况。结果246例采用硬膜外麻醉,34例为鞍区麻醉。手术顺利,手术时间28~190min,平均(47·6±19·5)min,无输血患者。术后全部留置尿管;留置尿管时间12~120h,平均(32·6±19·4)h,4例拔除尿管后出现短暂排尿困难,3例迟发性出血,无尿失禁等并发症发生。术后随访3~6个月,最大尿流率由术前平均(6·1±2·5)ml/s增加至术后(18·8±3·2)ml/s,IPSS与术前比较有显著改善,差异有统计学意义(P<0·05)。结论PVP治疗BPH的操作简单、时间短、出血少,留置尿管时间短,尤其适合于高龄、高危患者。
Objective To explore the method and evaluate the efficacy of selective green laser prostatic vaporization (PVP) in the treatment of benign prostatic hyperplasia (BPH). Methods Continuous epidural anesthesia and sellar anesthesia were used. 280 patients with BPH were treated with PVP. Variations of vaporization, bleeding, operation time, postoperative catheterization time, preoperative and postoperative urinary flow rate and International Prostate Symptom Score (IPSS) were observed. Results of 246 cases of epidural anesthesia, 34 cases of sellar anesthesia. The operation was smooth and the operation time was 28 to 190 minutes (mean, 47.6 ± 19.5 min). There was no blood transfusion in patients. All the catheters were placed indwellingly, the time of indwelling catheter was 12 ~ 120h (average 32.6 ± 19.4) h, 4 patients had short-term dysuria after removing the catheter, 3 patients had delayed bleeding and no urinary incontinence Disease occurs. After 3 to 6 months of follow-up, the maximum flow rate increased from (6.1 ± 2.5) ml / s to (18.8 ± 3.2) ml / s preoperatively Compared with significant improvement, the difference was statistically significant (P <0 · 05). Conclusion The treatment of BPH by PVP is simple, short time, less bleeding and shorter catheter stay, especially suitable for elderly and high-risk patients.