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目的探讨铥激光前列腺切除术(thulium laser resection of prostate,TmLRP)治疗良性前列腺增生症(benignprostate hyperplasia,BPH)的手术方法并评估其安全性和有效性。方法应用50W波长2μm连续波铥激光对32例BPH行TmLRP。前列腺体积(48.2±21.5)ml,术前IPSS评分(24.4±6.7)分,最大尿流率(7.6±3.4)ml/s。结果手术时间(52.8±20.2)min,术中无明显出血,无手术并发症,术前术后血K+、Na+、Cl-浓度及血红蛋白差异无显著性(P>0.05)。术后导尿管留置时间平均2.5d(2~4)d。随访时间5~24个月,平均17个月。术后1个月IPSS评分(6.7±2.4)分,最大尿流率(16.3±6.1)ml/s,与术前(24.4±6.7)分、(7.6±3.4)ml/s相比明显改善(t=8.975、7.325,P<0.05)。结论铥激光前列腺切除术是一项简单有效、微创、并发症少的理想手术方法,其效果同TURP术相当,且安全性高。
Objective To investigate the surgical treatment of benign prostatic hyperplasia (BPH) with thulium laser resection of prostate (TmLRP) and evaluate its safety and efficacy. Methods Twenty-two BPH TmLRP were performed with 50 W wavelength 2 μm continuous wave laser. Prostate volume (48.2 ± 21.5) ml, preoperative IPSS score (24.4 ± 6.7) and maximal uroflow rate (7.6 ± 3.4) ml / s. Results The operation time was 52.8 ± 20.2 min. There was no obvious hemorrhage and no complications during operation. There was no significant difference in K +, Na +, Cl- concentration and hemoglobin before operation (P> 0.05). Postoperative catheter retention time averaging 2.5d (2 ~ 4) d. Follow-up time of 5 to 24 months, an average of 17 months. The IPSS score (6.7 ± 2.4) and the maximum uroflow rate (16.3 ± 6.1) ml / s at one month postoperatively were significantly improved compared with preoperative (24.4 ± 6.7) and (7.6 ± 3.4) ml / s t = 8.975, 7.325, P <0.05). Conclusions 铥 Laser prostatectomy is a simple, effective and minimally invasive surgery with less complications. Its effect is equivalent to TURP and safe.