1470 nm双效能激光在前列腺增生症中的临床应用
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摘要
目的探讨1 470 nm双效能激光汽化术治疗良性前列腺增生症的临床疗效。方法 2016年7月至2017年6月,应用1 470 nm双效能激光汽化术治疗良性前列腺增生症患者52例,汽化功率150 W。术后3~6个月随访,观察与分析手术前后国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量指数(quality oflife,QOL)评分、最大尿流率(the maximum flow rate,Q_(max))及残余尿量(post-void residual volume,PVR)、手术时间、术前合并症及术后并发症,评价疗效。结果 52例前列腺增生症患者手术均获成功,手术时间20~82 min,平均(45. 0±12. 6)min。术后住院时间3~5 d,平均(3. 5±1. 2)d。术后IPSS评分、QOL评分、Q_(max)及PVR明显优于术前,差异均具有统计学意义(P<0. 05)。术中、术后均无明显并发症发生。结论 1 470 nm双效能激光汽化术是治疗中等大小前列腺增生患者安全有效的微创治疗方法,尤其对于高龄、高危患者具有手术时间短、出血少、恢复快、住院时间缩短等优势。
Objective To investigate the clinical efficacy of 1 470 nm double-effect laser vaporization in the treatment of benign prostatic hyperplasia.Methods Totally 52 patients of benign prostatic hyperplasia treated with 1 470 nm dual-function laser during the period from Jul.2016 to Jun. 2017 were selected for the study. The international prostate symptom score(IPSS), quality of life score(QOL),maximum urinary flow rate(Q_(max)), residual urine volume(PVR), operation time, preoperative complications and postoperative complications before and after the surgery were observed and analyzed. The efficacy was evaluated after 3-6 months' follow-up.Results The 1 470 nm double-effect laser vaporization was conducted successfully for all the 52 patients. After the operation, the IPSS scores, QOL scores, Q_(max) and PVR were significantly improved. The differences of the indexes before and after the surgery were statistically significant(P<0. 05). The operation time was 20-82 min,(45. 0± 12. 6) min on average. The postoperative hospital stay lasted for 3-5 days,averaging(3. 5±1. 2) days. No significant complication occurred during or after the surgery.Conclusion The 1 470 nm double-effect laser vaporization is a safe and effective minimally invasive treatment for patients with moderate-grade benign prostatic hypeplasia. Especially for elderly patients and high-risk patients, it has the advantages of short operation time, less bleeding, quicker recovery, and shorter hospital stay.
Objective To investigate the clinical efficacy of 1 470 nm double-effect laser vaporization in the treatment of benign prostatic hyperplasia.Methods Totally 52 patients of benign prostatic hyperplasia treated with 1 470 nm dual-function laser during the period from Jul.2016 to Jun. 2017 were selected for the study. The international prostate symptom score(IPSS), quality of life score(QOL),maximum urinary flow rate(Q_(max)), residual urine volume(PVR), operation time, preoperative complications and postoperative complications before and after the surgery were observed and analyzed. The efficacy was evaluated after 3-6 months' follow-up.Results The 1 470 nm double-effect laser vaporization was conducted successfully for all the 52 patients. After the operation, the IPSS scores, QOL scores, Q_(max) and PVR were significantly improved. The differences of the indexes before and after the surgery were statistically significant(P<0. 05). The operation time was 20-82 min,(45. 0± 12. 6) min on average. The postoperative hospital stay lasted for 3-5 days,averaging(3. 5±1. 2) days. No significant complication occurred during or after the surgery.Conclusion The 1 470 nm double-effect laser vaporization is a safe and effective minimally invasive treatment for patients with moderate-grade benign prostatic hypeplasia. Especially for elderly patients and high-risk patients, it has the advantages of short operation time, less bleeding, quicker recovery, and shorter hospital stay.
引文
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[7]Wu G,Hong Z,Li C,et al.A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hy-perplasia:a randomized clinical trial with 12-month fol-low-up[J].Lasers Med Sci,2016,31:599-604.
[8]曹会彦,刘智明,乜国雁,等.1 470 nm半导体激光经尿道前列腺汽化术治疗BPH的疗效观察[J].临床泌尿外科杂志,2014,29:794-796,799.
[9]刘志峰,赵永伟,刘义东,等.1 470 nm半导体激光汽化术治疗前列腺增生(附156例报告)[J].微创泌尿外科杂志,2015,3:20-22.
[10]潘道勇,刘成,刘雪军,等.1 470 nm半导体激光前列腺汽化术与经尿道前列腺电切术治疗良性前列腺增生的效果比较[J].中国综合临床,2015,4:20-22.
[11]朱玲敏,李春花,黄婷,等.1 470 nm半导体激光前列腺汽化剜除术围手术期护理[J].中国激光医学杂志,2018,27:120.
[12]郑春梅,杜现梅,张斯棋,等.B超检查对良性前列腺增生症诊断的临床研究[J].健康必读,2018,27:68.
[13]Liu Z,Zhao Y,Wang X,et al.Critical reviews of 1 470nm laser vaporization on benign prostatic hyperplasia[J].Lasers Med Sci.2018,33:323-327.
[14]Zhao Y,Liu C,Zhou G,et al.A retrospective evaluation of benign prostatic hyperplasia treatment by transurethral vaporization using a 1 470 nm laser[J].Photomed Laser Surg.2013,31:626-629.
[15]高江涛,景治安,刘彦军,等.1 470 nm半导体激光对大体积前列腺患者疗效评价及比较[J].黑龙江医学,2017,41:625-627.
[2]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014.249-251,259.
[3]Nair SM,Pimentel MA,Gilling PJ.Areview of laser treat-ment for symptomatic BPH(Benign Prostatic Hyperpla-sia)[J].Curr Urol Rep,2016,17:45.
[4]Fayad AS,Sheik HMG,Zakaria T,et al.Holmium laser enucleation versus bipolar resection of the prostate:apro-spectiver and omized study.Which to choose[J]?J Endo urol,2011,25:1347-1352.
[5]刘萃龙,周茂军,赵豫波,等.1 470 nm半导体激光汽化术治疗良性前列腺增生症[J].微创泌尿外科杂志,2014,3:112-114.
[6]Seitz M,Sroka R,Gratzke C,et al.The diode laser:a novel side-firing approach for laser vaporisation of the hu-man prostate-immediate efficacy and 1 year follow-up[J].Eur Urol,2007,52:1717-1722.
[7]Wu G,Hong Z,Li C,et al.A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hy-perplasia:a randomized clinical trial with 12-month fol-low-up[J].Lasers Med Sci,2016,31:599-604.
[8]曹会彦,刘智明,乜国雁,等.1 470 nm半导体激光经尿道前列腺汽化术治疗BPH的疗效观察[J].临床泌尿外科杂志,2014,29:794-796,799.
[9]刘志峰,赵永伟,刘义东,等.1 470 nm半导体激光汽化术治疗前列腺增生(附156例报告)[J].微创泌尿外科杂志,2015,3:20-22.
[10]潘道勇,刘成,刘雪军,等.1 470 nm半导体激光前列腺汽化术与经尿道前列腺电切术治疗良性前列腺增生的效果比较[J].中国综合临床,2015,4:20-22.
[11]朱玲敏,李春花,黄婷,等.1 470 nm半导体激光前列腺汽化剜除术围手术期护理[J].中国激光医学杂志,2018,27:120.
[12]郑春梅,杜现梅,张斯棋,等.B超检查对良性前列腺增生症诊断的临床研究[J].健康必读,2018,27:68.
[13]Liu Z,Zhao Y,Wang X,et al.Critical reviews of 1 470nm laser vaporization on benign prostatic hyperplasia[J].Lasers Med Sci.2018,33:323-327.
[14]Zhao Y,Liu C,Zhou G,et al.A retrospective evaluation of benign prostatic hyperplasia treatment by transurethral vaporization using a 1 470 nm laser[J].Photomed Laser Surg.2013,31:626-629.
[15]高江涛,景治安,刘彦军,等.1 470 nm半导体激光对大体积前列腺患者疗效评价及比较[J].黑龙江医学,2017,41:625-627.