论文部分内容阅读
目的:探讨经尿道1470 nm半导体激光汽化切割术治疗高危前列腺增生症临床效果与安全性。方法:回顾性分析2016年1~10月在我院接受经尿道1470 nm半导体激光汽化切割术42例高危前列腺患者临床资料。所有患者均有明显进行性排尿困难,经泌尿系彩超、肛门指检、PSA、前列腺穿刺活检等明确前列腺增生诊断,排除前列腺癌。每位患者均合并1种或1种以上老年性基础疾病,如糖尿病、高血压、冠心病、肺气肿、脑梗死后遗症等。观察患者术中生命体征变化、出血情况、手术持续时间、术后膀胱冲洗时间、尿管保留时间、继发性出血以及手术前后红细胞、血红蛋白、红细胞压积、血清钾、钠变化情况,以评价手术安全性;术后2个月评估国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)与术前比较,以评价手术效果。结果:42例手术均顺利完成,术中患者生命体征平稳,平均手术时间(81.1±35.7)min,术中几乎无出血,术后膀胱冲洗时间(19.1±9.2)h,术后尿管平均保留时间(4.5±0.6)d,术后平均住院日(5.4±1.3)d,手术前后红细胞、血红蛋白、红细胞压积、血清钾、钠等无显著改变(P>0.05),随访2个月,IPSS、QOL、Qmax、PVR各指标较术前明显改善(P<0.05),无大出血、尿失禁、心肺功能衰竭及明显的尿路刺激症状等发生。结论:经尿道1470 nm半导体激光治疗高危前列腺增生具有安全性高、效果显著等优点,尤其适合高危前列腺患者。
Objective: To investigate the clinical effect and safety of transurethral laser lithotripsy at 1470 nm in the treatment of benign prostatic hyperplasia. Methods: The clinical data of 42 high-risk prostate patients receiving transurethral laser 1470 nm transurethral laser vaporization in our hospital from January to October 2016 were analyzed retrospectively. All patients had significant progressive dysuria, urinary system ultrasound, anus, PSA, prostate biopsy and other clear diagnosis of benign prostatic hyperplasia, rule out prostate cancer. Each patient was combined with one or more of age-related underlying diseases such as diabetes, hypertension, coronary heart disease, emphysema, cerebral infarction and other sequelae. Changes of vital signs, bleeding, duration of surgery, postoperative bladder irrigation time, catheter retention time, secondary hemorrhage and changes of red blood cells, hemoglobin, hematocrit, serum potassium and sodium before and after surgery were observed to evaluate the changes Surgical safety was evaluated. IPSS, QOL, Qmax and residual PVR were evaluated at 2 months after surgery to compare the preoperative outcomes. Results: All the 42 cases were successfully performed. The vital signs of patients were stable during operation. The mean operative time was 81.1 ± 35.7 min. There was almost no bleeding during operation. The postoperative bladder irrigation time was 19.1 ± 9.2 h. (4.5 ± 0.6) d, average postoperative hospital stay (5.4 ± 1.3) days, no significant change of erythrocyte, hemoglobin, hematocrit, serum potassium and sodium before and after operation (P> 0.05) , QOL, Qmax and PVR were all significantly improved compared with those before operation (P <0.05). No major bleeding, urinary incontinence, cardiopulmonary failure and obvious symptoms of urinary tract irritation occurred. Conclusion: The transurethral 1470 nm laser diode laser treatment of high-risk benign prostatic hyperplasia with high safety, the effect is significant, etc., especially for high-risk patients with prostate.