目的 探讨经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)整叶改良法治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的效果。方法 选择2015-11至2018-02武警山西总队医院应用钬激光经尿道行前列腺整叶剜除改良法治疗的BPH患者,共117例,观察术中安全性、手术前后最大尿流率(Qmax)、国际前列腺症状评分(IPSS)。结果 117例手术时间30～150 min,平均(106.0±30.5)min。膀胱冲洗时间12～48 h,平均(36.0±9.8) h。术后留置尿管3～8 d,平均(4.0±1.7)d。住院时间5～14d,平均(8.0±2.8)d。术后3个月IPSS从术前(23.2±6.4)降至(5.1±2.5),Qmax从术前(4.4±2.3)ml/s增加至(19.5±7.5)ml/s。无严重并发症。结论 整叶法经尿道前列腺钬激光剜除术治疗BPH手术过程安全,无严重并发症,尤其适用于高龄、高危患者,效果满意。
Abstract
Objective To study the clinical advantages and efficacy of holmium laser enucleation of the prostate for benign prostatic hyperplasia. Methods In this study, 117 cases of benign prostatic hyperplasia were treated with holmium laser enucleation of the prostate in Shanxi Provincial Corps Hospital between November 2015 and February 2018. Intraoperative safety, preoperative and postoperative maximal urinary flow rate (Qmax) and the International Prostate Symptom Score (IPSS) were observed. Results The duration of surgery ranged from 30 to 150 minutes, with an average of (106.0±30.5) minutes. The duration of bladder irrigation was 12 to 48 hours, with an average of (36.0±9.8)hours. The urinary catheter was left for 3 to 8 days after operation, with an average of (4.0±1.7) days. The length of hospital stay was 5 to 14 days, with an average of (8.0±2.8) days. At 3 months after surgery, IPSS decreased from(23.2±6.4)to(5.1±2.5), and Qmax increased from (4.4±2.3)ml/s before surgery to (19.5±7.5)ml/s. No serious complications occurred. Conclusions HoLEP is safe in the treatment of BPH without serious complications. It is the right approach for elderly and high-risk patients with satisfactory results.
关键词
前列腺增生 /
钬激光 /
剜除术
Key words
benign prostatic hyperplasia /
holmium laser /
enucleation
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参考文献
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