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目的:探讨经尿道120 W 2μm激光前列腺剜除术治疗良性前列腺增生(BPH)的手术操作技巧,评价其有效性和安全性。方法:82例BPH患者应用120 W 2μm激光前列腺剜除术治疗,前列腺超声测得前列腺体积30～160 ml,平均(60.2±15.8)ml。记录术中操作时间、出血量、手术前后尿动力学参数及术后并发症。结果:手术均顺利完成。手术时间32～145 min,平均(72.0±26.6)min,无输血病例。平均留置尿管3.6天。8例术后出现并发症,包括暂时出血2例,5例泌尿系感染1例,1例因泌尿系感染术后1周后再次置入尿管,无尿失禁。术后随访3～12个月,平均最大尿流率(Q_(max))由术前(3.5±4.7)ml/s增至(18.6±5.6)ml/s,剩余尿量(PVR)(125.4±218.4)ml降至(23.4±31.5)ml。大体积(≥60 ml)和小体积(<60 ml)前列腺两组患者留置尿管时间、Q_(max)、PVR等差异无统计学意义。结论:120 W 2μm激光前列腺剜除术治疗BPH效果良好,并发症少,学习曲线较短,且不受前列腺体积限制。但应注意手术技巧的掌握。
Objective: To investigate the surgical technique of transurethral resection of the prostate with 120 W 2 μm laser for the treatment of benign prostatic hyperplasia (BPH) and to evaluate its effectiveness and safety. Methods: Eighty - two patients with BPH were treated with 120 W 2μm laser prostatectomy. Prostate volume was 30 ~ 160 ml (mean 60.2 ± 15.8) ml. The operation time, bleeding volume, urodynamic parameters before and after surgery and postoperative complications were recorded. Results: All the operations were completed successfully. The operation time ranged from 32 to 145 minutes, with an average of (72.0 ± 26.6) min, with no transfusion cases. The average catheter 3.6 days. Eight cases had postoperative complications including transient hemorrhage in 2 cases, 5 cases of urinary tract infection in 1 case, and 1 case of urinary tract infection in 1 week postoperatively. The mean maximum flow rate (Q max) increased from 3.5 ± 4.7 ml / s to 18.6 ± 5.6 ml / s and the residual urine volume (PVR) was 125.4 ± 218.4) ml to (23.4 ± 31.5) ml. There was no significant difference in the time of catheterization, Q max, PVR between the two groups of large volume (≥60 ml) and small volume (<60 ml) of prostate. Conclusion: 120 W 2 μm laser prostatectomy is effective in treating BPH with few complications and short learning curve, and is not limited by the volume of the prostate. But should pay attention to the mastery of surgical techniques.