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目的探讨经尿道2μm激光治疗高龄高危患者良性前列腺增生(benign prostatic hyperplasia,BPH)的有效性和安全性。方法对86例75~95岁高龄高危BPH患者行经尿道2μm激光治疗术,观察手术时间、出血量、血清钠变化、手术并发症、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)等指标,术后随访6个月。结果 86例患者激光治疗术均获成功,手术时间(42.8±32.2)min,留置尿管(3.2±2.4)d。手术前后血红蛋白分别为(132±19)g/L和(126±22)g/L,血清钠分别为(142.6±4.6)mmol/L和(141.7±3.9)mmol/L,手术前后两组指标比较,差异均无统计学意义(P>0.05)。术后随访,IPSS和QOL评分分别由术前的(21.6±5.2)分和(4.3±0.7)分降至(6.8±2.0)分和(2.0±0.2)分;Qmax由术前的(7.2±3.6)ml/s升至(22.2±6.1)ml/s;残余尿量由术前的(160.6±26.6)ml降至(28.5±6.5)ml,手术前后各组指标比较,差异均有统计学意义(P﹤0.05)。结论经尿道2μm激光治疗高龄高危BPH患者安全、有效。
Objective To investigate the efficacy and safety of transurethral 2 μm laser in the treatment of benign prostatic hyperplasia (BPH) in elderly patients at high risk. Methods A total of 86 high-risk BPH patients aged 75-95 years were treated with 2 μm laser in the urethra. The operative time, blood loss, serum sodium change, surgical complications, IPSS, QOL, Urine flow rate (Qmax), residual urine volume (PVR) and other indicators were followed up for 6 months. Results 86 cases of laser treatment were successful, the operation time (42.8 ± 32.2) min, indwelling catheter (3.2 ± 2.4) d. The levels of hemoglobin before and after surgery were (132 ± 19) g / L and (126 ± 22) g / L respectively, and the serum sodium levels were (142.6 ± 4.6) mmol / L and (141.7 ± 3.9) mmol / L respectively There was no significant difference between the two groups (P> 0.05). Postoperative follow-up, IPSS and QOL scores decreased from (21.6 ± 5.2) and (4.3 ± 0.7) points to (6.8 ± 2.0) and (2.0 ± 0.2) points, respectively; 3.6) ml / s to (22.2 ± 6.1) ml / s, and the residual urine volume decreased from (160.6 ± 26.6) ml to (28.5 ± 6.5) ml before and after operation. There were statistically significant differences Significance (P <0.05). Conclusion Transurethral 2 μm laser treatment of elderly patients with high-risk BPH is safe and effective.