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目的探讨2μm激光汽化术治疗晚期前列腺癌下尿路梗阻疗效。方法从2012年2月至2013年9月,我院采用2μm激光汽化术治疗晚期前列腺癌下尿路梗阻患者26例,术前评估准备、观察平均手术时间、血浆血红蛋白降低,术前、后国际前列腺症状评分(IPSS)、生活质量评分(Qo L)、残余尿量(RUV)及最大尿流率(Qmax)变化等指标。结果 26例患者手术成功,手术病人无输血,没有患者出现前列腺电切综合征。平均手术时间为(81.2±24.4)min,平均血红蛋白下降(6.4±3.2)g/L。术前PSA,IPSS,Qo L,Qmax,RUV分别为(13.9±4.2)μg/m L,(23.6±4.1),(5.9±1.2),(7.3±2.3)m L/s,(147.3±55.4)m L。术后1个月随访PSA,IPSS,Qo L,Qmax,RUV变化,分别为(1.6±0.8)μg/m L,(8.8±2.9),(2.4±0.8),(15.8±3.6)m L/s,(40.6±19.3)m L。手术前后各项指标差异均有统计学意义(P<0.01)。结论 2μm激光汽化术针对治疗晚期前列腺癌下尿路梗阻是安全有效的微创手术方式。
Objective To investigate the therapeutic effect of 2μm laser vaporization on lower urinary tract obstruction in advanced prostate cancer. Methods From February 2012 to September 2013, 26 patients with advanced prostate cancer lower urinary tract obstruction were treated with 2μm laser vaporization in our hospital. Preoperative evaluation preparation, mean operative time, reduction of plasma hemoglobin, preoperative and postoperative international Prostate Symptom Score (IPSS), Quality of Life Score (Qo L), Residual Urine Volume (RUV) and Maximal Urine Flow Rate (Qmax). Results Twenty-six patients underwent surgery successfully. There was no blood transfusion in the surgical patients and none of the patients had prostate resection syndrome. The average operation time was (81.2 ± 24.4) min, mean hemoglobin decreased (6.4 ± 3.2) g / L. The preoperative PSA, IPSS, QoL, Qmax and RUV were (13.9 ± 4.2) μg / m L, (23.6 ± 4.1), (5.9 ± 1.2), (7.3 ± 2.3) m L / s and (147.3 ± 55.4) ) m L. The changes of PSA, IPSS, QoL, Qmax and RUV at 1 month after operation were (1.6 ± 0.8) μg / m L, (8.8 ± 2.9), (2.4 ± 0.8) and (15.8 ± 3.6) m L / s, (40.6 ± 19.3) m L. The indexes before and after surgery showed significant difference (P <0.01). Conclusion 2 μm laser vaporization is a safe and effective minimally invasive surgical treatment of lower urinary tract obstruction of advanced prostate cancer.