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目的 :评价经尿道钬激光前列腺剜除和前列腺组织粉碎术治疗良性前列腺增生 (BPH)的临床效果。 方法 :应用 10 0W钬激光器和组织粉碎器对 35例BPH病人实施经尿道钬激光剜除和前列腺组织粉碎术治疗。 结果 :本组 35例手术均获成功。手术时间 30～ 180min ,平均 (6 0 .0± 2 3.2 )min。获得前列腺组织 10～ 5 6g ,平均(31± 9) g ,术后留置导尿管时间 2 0h～ 4d ,平均1.5d。无术中术后输血病例。组织病理学诊断均为BPH。 32例获随访 ,术后 3个月随访国际前列腺症状评分 (IPSS)由 (2 4.0± 6 .2 )分降至 (5 .6± 3.6 )分 (P <0 .0 0 1)。最大尿流率 (Qmax)由 (8.5± 3.9)ml/s上升至 (2 2 .0± 7.2 )ml/s(P <0 .0 0 1) ,残余尿由 (138± 12 5 )ml减少到 (2 1± 15 )ml,未发生严重并发症。 结论 :钬激光前列腺剜除术是治疗BPH的有效微创方法 ,术中术后出血少 ,能够完整剜除增生的前列腺组织。留置导尿管时间短 ,临床症状改善明显。
Objective: To evaluate the clinical effect of transurethral holmium laser prostatectomy and prostatic tissue crush in the treatment of benign prostatic hyperplasia (BPH). Methods: 35 cases of BPH were treated by transurethral holmium laser excision and prostate tissue pulverization with 100 W holmium laser and tissue pulverizer. Results: All the 35 cases in this group were successful. The operation time was 30 ~ 180min, with an average of (600 ± 2 3.2) min. Prostate tissue obtained 10 ~ 5 6g, an average of (31 ± 9) g, postoperative indwelling catheter 20h ~ 4d, an average of 1.5d. No intraoperative blood transfusion cases. Histopathological diagnosis is BPH. Thirty-two patients were followed up and the International Prostate Symptom Score (IPSS) was decreased from (2 4.0 ± 6.2) points to (5.6 ± 3.6) points (P0.01) at 3 months after operation. The maximal flow rate (Qmax) increased from (8.5 ± 3.9) ml / s to (220 ± 7.2) ml / s (P0.001) and the residual urine decreased from (138 ± 125) ml To (21 ± 15) ml, no serious complications occurred. Conclusions: Holmium laser prostatectomy is an effective and minimally invasive method for the treatment of BPH. Postoperative bleeding is less and the hyperplastic prostate tissue can be removed completely. Catheter indwelling time is short, significant improvement in clinical symptoms.