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目的:探讨经尿道选择性绿激光前列腺汽化术(PVP)治疗BPH的有效性和安全性。方法:采用PVP治疗BPH患者156例,并对手术前后相关指标进行比较观察。结果:156例手术均顺利,手术时间平均(44.5±23.8)min,术中出血量(43.2±16.4)ml,无输血病例。术后32例未留置尿管,余124例留置尿管时间12～36h,平均(15.2±4.6)h;拔除尿管后排尿均通畅,无尿失禁等并发症发生。术后随访4～14个月,国际前列腺症状评分(IPSS)由术前28.6±2.4下降至术后6.4±0.6,最大尿流率由术前平均(5.3±0.5)ml/s升至术后(19.1±1.8)ml/s;生活质量评分(QOL)由术前平均5.4±0.6下降至术后1.2±0.7,剩余尿量由术前(254.6±69.7)ml下降至术后(20.5±4.6)ml。手术前后比较差异均有统计学意义(P<0.05)。结论:PVP治疗BPH疗效显著,并发症少,安全性高,是一种理想的微创手术。
Objective: To investigate the efficacy and safety of transurethral selective green laser prostatic vaporization (PVP) in the treatment of BPH. Methods: 156 cases of patients with BPH were treated with PVP, and the related indexes before and after operation were compared. Results: All the 156 cases were operated smoothly. The mean operation time was (44.5 ± 23.8) min and the amount of intraoperative blood loss was (43.2 ± 16.4) ml. No blood transfusion cases were found. After operation, 32 cases had no indwelling catheter, and 124 cases had indwelling catheter for 12-36 hours with an average of (15.2 ± 4.6) hours. Urinary excretion was unobstructed after urinary catheter ablation, and complications such as incontinence did not occur. After 4 to 14 months of follow-up, the International Prostate Symptom Score (IPSS) decreased from 28.6 ± 2.4 preoperatively to 6.4 ± 0.6 postoperatively, and the maximum flow rate increased from 5.3 ± 0.5 ml / s preoperatively (19.1 ± 1.8) ml / s.The quality of life (QOL) decreased from 5.4 ± 0.6 preoperatively to 1.2 ± 0.7 postoperatively, while the residual urine volume decreased from 254.6 ± 69.7 to 20.5 ± 4.6 postoperatively ) ml. The differences between before and after surgery were statistically significant (P <0.05). Conclusion: PVP has a significant effect in treating BPH with less complications and high safety. It is an ideal minimally invasive surgery.