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目的观察经尿道前列腺2μm激光汽化切除联合电切治疗重度前列腺增生的安全性及有效性。方法经尿道前列腺2μm激光汽化切除联合电切治疗86例重度前列腺增生患者,比较患者术前术后的国际前列腺症状评分(IPSS)、生活质量评估(QOL)、最大尿流率(Qmax)、残余尿量(RUV)和夜尿次数以及血Na+、血红蛋白水平;术后评估患者手术时间、出血量、膀胱冲洗时间、留置尿管时间、住院时间及并发症情况。结果 85例成功完成手术,1例转为开放手术,术后下尿路梗阻症状均有不同程度改善。术前及术后血Na+、血红蛋白水平差异无统计学意义(P>0.05),术前及术后3个月IPSS、QOL、Qmax、RUV及夜尿次数差异均有统计学意义(P<0.05)。手术时间平均(131±18.6)min,术中出血量(32±10.4)ml,术后膀胱冲洗时间0.5~2 d,留置尿管时间5~7 d,总住院时间8~10 d,所有患者术中术后均无严重的并发症发生。结论经尿道前列腺2μm激光汽化切除联合电切治疗重度前列腺增生安全、有效,术中出血少,术后恢复快,治疗效果满意。
Objective To observe the safety and efficacy of transurethral resection of the prostate by 2μm laser vaporization combined with electrotomy for severe prostatic hyperplasia. Methods Twenty-six patients with severe prostatic hyperplasia (BPH) underwent transurethral resection of the prostate with 2μm laser vaporization and electrotomy. The patients’ IPSS, QOL, Qmax, residual Urine output (RUV) and nocturnal urination, blood Na + and hemoglobin. Postoperatively, operation time, blood loss, bladder irrigation time, indwelling catheter time, hospital stay and complications were evaluated. Results 85 cases completed the operation successfully, and 1 case turned into an open operation. The symptoms of lower urinary tract obstruction after operation were improved to some extent. The levels of Na + and hemoglobin in preoperative and postoperative blood had no significant difference (P> 0.05), and there were significant differences in IPSS, QOL, Qmax, RUV and nocturnal frequency in preoperative and postoperative 3 months (P <0.05 ). The operation time was (131 ± 18.6) min, intraoperative blood loss (32 ± 10.4) ml, postoperative bladder irrigation time 0.5 ~ 2 days, indwelling catheter time 5 ~ 7 days, total hospital stay 8 ~ 10 days. All patients No intraoperative and postoperative complications occurred. Conclusions Transurethral resection of the prostate by 2μm laser vaporization combined with resection of the prostate for the treatment of severe benign prostatic hyperplasia is safe and effective, with less intraoperative bleeding and rapid postoperative recovery. The therapeutic effect is satisfactory.