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目的:探讨大功率2μm激光汽化切除术治疗BPH的临床疗效及安全性,为2μm激光微创治疗BPH奠定基础。方法:采用大功率2μm激光“五分法”(激光组)与经尿道前列腺电切术(TURP组)治疗BPH患者各120例,对两组的手术时间、出血量、术后膀胱冲洗液量及冲洗时间、术后留置导尿管时间及国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)等指标进行对比分析。结果:激光组手术经过顺利,术后无继发出血,无尿失禁发生;TURP组118例手术经过顺利,2例出血较多,其中1例中转开放手术,1例姑息切除留置导尿管压迫止血结束手术。术后出现急迫性尿失禁2例,经提肛锻炼及理疗好转。两组术后排尿症状(IPSS和Qmax)及生活质量(QOL)改善方面差异无统计学意义(P>0.05)。术中术后出血量、术后留置导尿管时间及膀胱冲洗时间与TURP比较差异有统计学意义(P<0.05)。结论:2μm激光前列腺汽化切除术治疗BPH是安全有效的新型腔内微创手术方法,临床疗效及手术时间同于TURP,手术出血量、留置导尿管时间及膀胱冲洗时间较TURP有明显优势,且避免TUR综合征及闭孔反射的发生,有可能成为治疗BPH的新标准。
Objective: To investigate the clinical efficacy and safety of high-power 2 μm laser vaporization in the treatment of BPH and lay a foundation for the treatment of BPH with 2 μm laser minimally invasive treatment. Methods: A total of 120 BPH patients were treated with high power 2μm laser “five points method” (laser group) and transurethral resection of the prostate (TURP group). The operation time, blood loss, postoperative bladder irrigation Fluid volume and irrigation time, time of postoperative indwelling catheter, IPSS, QOL and Qmax were compared and analyzed. Results: There was no postoperative bleeding and no urinary incontinence in the laser group. The operation of 118 cases in the TURP group went smoothly and the hemorrhage in 2 cases was more. Among them, 1 case underwent open surgery and 1 case underwent palliative catheterization Stop bleeding surgery. Postoperative urinary incontinence in 2 cases, the levator ani exercise and physical therapy improved. There were no significant differences in urination symptoms (IPSS and Qmax) and quality of life (QOL) between the two groups (P> 0.05). The postoperative blood loss, postoperative indwelling catheter time and bladder irrigation time were significantly different from TURP (P <0.05). Conclusions: 2 μm laser vaporization resection for BPH is a safe and effective method for minimally invasive surgery. The clinical curative effect and operation time are the same as those of TURP, the amount of bleeding during operation, the duration of indwelling catheter and the time of bladder irrigation, And to avoid the occurrence of TUR syndrome and obturator reflex, may become the new standard for the treatment of BPH.