摘要
目的探讨1470 nm激光前列腺剜除汽化术治疗复杂性前列腺增生患者临床疗效,为患者的治疗及康复提供指导。方法选择2017年3月至2018年10月来我院就诊治疗的前列腺增生患者50例作为研究对象,所有患者都采用1470 nm激光前列腺剜除汽化术治疗。观察手术时间、术中出血量、膀胱冲洗时间、留置导尿管时间和住院时间,观察并记录手术前后国际前例腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流量(Qmax)和残余尿量(PVR)指标变化,还有术前和术后2 h血红蛋白(Hb)和血清钠离子浓度变化情况。结果50例患者均顺利完成手术,手术时间(94.02±20.31)min,术中出血量(30.12±10.11)mL,术后膀胱冲洗时间(1.91±0.52)d,留置导尿管时间(3.25±0.81)d,住院时间(6.12±2.01)d。与术前相比,术后IPSS评分和QOL评分均明显下降(P<0.05),Qmax明显升高和PVR均明显减少,差异有统计学意义(P<0.05)。患者术前和术后Hb无显著变化(P>0.05),都属于正常范围内,术后血清钠离子浓度低于术前。患者在术中没有直肠和膀胱穿孔现象发生,在术后没有输血、电切综合征、永久性尿失禁、和尿道狭窄等并发症发生,仅出现2例膀胱痉挛。结论1470 nm激光前列腺剜除汽化术治疗复杂性前列腺增生,其术中视野良好,无出血,创伤小,包膜完整无刺激,安全性高,并发症少,术后患者没有尿失禁出现,恢复快,非常值得临床上推广应用。
Objective To investigate the clinical efficacy of complex benign prostatic hyperplasia treated by 1470 nm laser prostatectomy,and provide instruction for patients’treatment and recovery.Methods 50 patients with benign prostatic hyperplasia admitted to our hospital from March 2017 to October 2018 were selected as subjects.All patients were treated with 1470 nm laser prostatectomy.The operation time,the intraoperative blood loss,the postoperative bladder irrigation time,catheter indwelling time,and the length of hospital stay were observed.Besides,the international prostate symptom score(IPSS),quality of life(QOL)score,maximum urine flow rates(Qmax)and postvoid residual volume(PVR)and changes in hemoglobin and serum sodium levels 2 h after operation and before operation were observed and recorded.Results The operations were successfully performed on the 50 patients.The operation time,intraoperative blood loss,postoperative bladder irrigation time,catheter indwelling time and length of hospital stay were(94.02±20.31)min,(30.12±10.11)mL,(1.91±0.52)d,(3.25±0.81)d,and(6.12±2.01)d,respectively.Compared with preoperative condition,the postoperative IPSS score and QOL score decreased significantly.Qmax increased evidently and PVR decreased significantly.The differences were statistically significant(P<0.05).There was no significant change in Hb before and after surgery which were both within the normal range.The serum sodium ion concentration after surgery was lower than that before surgery.There were no rectal and bladder perforations during the operation,and no complications such as blood transfusion,ransurethral resection syndrome,permanent urinary incontinence,and urethral stricture occurred after surgery,and only 2 patients had bladder spasm.Conclusion 1470 nm laser prostatectomy used in the treatment of complex benign prostatic hyperplasia has such advantages as good view,no bleeding,minor trauma,intact capsule without irritation,high safety,few complications,no urinary incontinence in patients after operation and fast recovery,which is worthy of clinical application.
作者
程伟文
陈咏佳
陈光耀
吴栩君
谭健秋
林燕文
Cheng Weiwen;Chen Yongjia;Chen Guangyao;Wu Xujun;Tan Jianqiu;Lin Yanwen(No.1 Division in the Urology Department,the People's Hospital of Yangjiang,Yangjiang 529500 China)
出处
《锦州医科大学学报》
CAS
2019年第6期60-63,共4页
Journal of Jinzhou Medical University
