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目的探讨选择性绿激光汽化术(PVP)治疗良性前列腺增生(BPH)的方法并评价其疗效。方法采用连续硬膜外麻醉,应用PVP治疗180例BPH患者。使用Laserscope公司生产的绿激光系统,平均功率80W,治疗时间20~140min[(42.5±19.4)min)],能量值10.2~54.2万焦耳[(12.4±5.6)万焦耳],术后留置尿管1~5d。结果术后52例出现一过性的终末血尿,12例暂时性尿失禁,18例短暂性排尿困难,3例迟发性出血。随访3~6个月,术后最大尿流率(Qmax)、IPSS评分、膀胱残余尿量(BRU)均较术前明显改善(P<0.05)。结论PVP治疗BPH操作简单,安全可靠,并发症少,恢复快,是治疗BPH的理想方法。
Objective To evaluate the efficacy and safety of selective green laser vaporization (PVP) in the treatment of benign prostatic hyperplasia (BPH). Methods Continuous epidural anesthesia was used to treat 180 BPH patients with PVP. Using Laserscope’s green laser system, the average power was 80 W and the duration of treatment was 20 to 140 minutes [(42.5 ± 19.4) min)] with an energy value of 10.2-542,000 joules [(12.4 ± 5.6) million joules) and postoperative indwelling catheter 1 ~ 5d. Results Postoperative 52 patients had transient terminal hematuria, 12 cases of transient urinary incontinence, 18 cases of transient dysuria and 3 cases of delayed bleeding. After 3 to 6 months of follow-up, the maximum postoperative flow rate (Qmax), IPSS score and bladder residual urine volume (BRU) were significantly improved (P <0.05). Conclusion The treatment of BPH by PVP is simple, safe and reliable, with fewer complications and faster recovery. It is an ideal method for the treatment of BPH.