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目的:探讨2μm激光剜除技术治疗高龄高危BPH患者的疗效和安全性。方法:患者年龄80～95岁,平均(85±3)岁。超声检测前列腺体积44～160ml,平均(74.5±19.4)ml。使用RevoLix 2μm激光剜除治疗112例高龄高危BPH患者。观察术中出血情况、手术时间、术后尿管留置时间、手术并发症,记录手术前后IPSS、QOL、Qmax及PVR等指标差异。结果:112例患者均顺利完成手术。输血7例,手术前后血电解质及血红蛋白浓度差异无统计学意义(P>0.05);平均手术时间(75±15)min;术后留置尿管5～7天。术后随访2～12个月,所有患者均未发生尿道狭窄,1例一过性尿失禁者1个月后恢复。IPSS评分及QOL评分分别从(27.3±5.4)和(4.8±0.2)降至(8.5±1.8)和(2.5±0.3);Qmax由术前(6.8±0.5)ml/s升至(16.9±1.6)ml/s;PVR由术前(67.0±1.2)ml下降至术后(13.3±3.4)ml,手术前后比较均差异有统计学意义(P<0.01)。结论:2μm激光剜除技术治疗高龄高危BPH安全有效。
Objective: To investigate the efficacy and safety of 2 μm laser ablation in the treatment of elderly patients with high-risk BPH. Methods: Patients aged 80 to 95 years, mean (85 ± 3) years. The volume of prostate was 44 ~ 160ml by ultrasound, with an average (74.5 ± 19.4) ml. One hundred and twelve elderly patients with high-risk BPH were treated with RevoLix 2μm laser ablation. The intraoperative bleeding, operation time, postoperative catheter indwelling time, operative complications were recorded. The indexes of IPSS, QOL, Qmax and PVR were recorded before and after operation. Results: All 112 patients completed the operation smoothly. There were no significant differences in blood electrolytes and hemoglobin concentrations before and after surgery in 7 cases (P> 0.05). The average operation time was 75 ± 15 minutes. The postoperative ureteral catheter was kept for 5 to 7 days. All cases were followed up for 2 to 12 months. No urethral stenosis occurred in all patients. One case of transient urinary incontinence recovered after one month. IPSS score and QOL score decreased from (27.3 ± 5.4) and (4.8 ± 0.2) to (8.5 ± 1.8) and (2.5 ± 0.3), respectively; Qmax increased from (6.8 ± 0.5) ml / s to (16.9 ± 1.6 ) ml / s. The PVR decreased from 67.0 ± 1.2 ml to 13.3 ± 3.4 ml before and after surgery, and the difference was statistically significant before and after operation (P <0.01). Conclusion: 2 μm laser ablation in elderly high-risk BPH is safe and effective.