1470nm激光治疗75岁以上良性前列腺增生患者的短期随访

doi:10.3969/j.issn.1009-976X.2020.04.016

摘要/Abstract

摘要： 目的报告75岁以上患者经尿道1470 nm激光前列腺剜除术后的随访结果。方法本课题采用前瞻性研究方法,选择2017年5月至2019年4月期间在我院接受经尿道1470 nm激光前列腺剜除术的62例患者作为研究对象,记录国际前列腺症状评分（IPSS）、尿流量（Qmax）、残余尿（PVR）、生活质量指数评分（QOL）在术后1年内的变化,包括PVR>150 mL以及前列腺体积>50 mL的特殊患者的术后情况。结果在所有62例患者中,58（93.5%）6个月内症状明显缓解,平均IPSS和QOL评分显著下降,并在整个随访期内保持不变;平均PVR从术前的近150 mL下降到32 mL（6个月）和30 mL（12个月）,平均Qmax从11.2 mL/s增加到1个月时的峰值14.1 mL/sL,12个月时达到14.2 mL/s,其中,PVR>150 mL以及前列腺体积>50 mL的患者的上述各项参数与总体间差异没有统计学意义（P>0.05）。结论 1470 nm激光前列腺剜除术明显改善了前列腺增生患者的下尿路症状和生活质量,前列腺体积和术前残余尿量不影响手术效果。

关键词: 1470 nm激光前列腺剜除术, 良性前列腺增生

Abstract: Objective To investigate the results of 1470nm laser vaporization on benign prostatic hyperplasia in patients over 75 years old. Methods In this study, 62 patients who underwent transurethral 1470 nm laser vaporization in our hospital from May 2017 to April 2019 were selected as the subjects. The changes of international prostate symptom score （IPSS）, maximum flow rate （Qmax）, post-void residual volume （PVR） and quality of life （QOL） in one year after operation were recorded, including those with PVR>50 ml and prostate volume>50 mL. Results In all 62 patients, 58 （93.5%） had significant symptom relief within one month, the average IPSS and QOL scores decreased significantly, and remained unchanged throughout the follow-up period.The average PVR decreased from nearly 150 mL before operation to 32 mL （6 months） and 30 mL （12 months）, the average Qmax increased from 11.2 mL/s to 14.1 mL/s at one month, and reached 14.2 mL/s at 12 months. There was no significant difference between the above parameters of patients with PVR>150 mL and prostate volume >50 mL （P>0.05）. Conclusion 1470 nm laser enucleation of prostate can improve the lower urinary tract symptoms and quality of life of patients with BPH. The volume of prostate and the amount of residual urine before operation do not affect the effect of operation.

Key words: benign prostatic hyperplasia, 1470-nm laser vaporization

中图分类号:

R697+.3

温剑辉, 邹伟波, 杨志添. 1470nm激光治疗75岁以上良性前列腺增生患者的短期随访[J]. 岭南现代临床外科, 2020, 20(04): 476-479.

WEN Jian-hui, ZOU Wei-bo, YANG Zhi-tian. Short term follow-up of 1470 nm laser vaporization on benign prostatic hyperplasia over 75 years old[J]. Lingnan Modern Clinics in Surgery, 2020, 20(04): 476-479.

参考文献

[1] Gratzke C, Bachmann A, Descazeaud A, et al.EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction[J]. Eur Urol, 2015, 67(6): 1099-1109.
[2] 罗耀雄, 王行环, 王怀鹏. 45岁以上男性下尿路症状与残余尿量相关性调查[J]. 岭南现代临床外科, 2007, 7(3): 200-201,219.
[3] Silva J, Silva CM, Cruz F.Current medical treatment of lower urinary tract symptoms/BPH: do we have a standard?[J]. Curr Opin Urol, 2014, 24(1): 21-28.
[4] Oelke M, et al.EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction[J]. Eur Urol, 2013, 64(1):118-140.
[5] Liu Z, Zhao Y, Wang X, et al.Critical reviews of 1470-nm laser vaporization on benign prostatic hyperplasia[J]. Lasers Med Sci, 2018, 33(2):323-327.
[6] 肖东根, 肖楚天, 庞後, 等. 1470 nm激光顺行法前列腺剜除术治疗前列腺增生[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(1): 4-7.
[7] 陈宁, 曹凤宏, 张立国, 等. 经尿道前列腺电切术与1470 nm半导体激光汽化术治疗前列腺增生的疗效比较[J]. 岭南现代临床外科, 2016, 16(1): 92-95.
[8] Kuntzman RS, Malek RS, Barrett DM.High-power potassium titanyl phosphate laser vaporization prostatectomy[J]. Mayo Clin Proc, 1998, 73(8): 798-801.
[9] Seitz M, Sroka R, Gratzke C, et al.The diode laser: a novel side-firing approach for laser vaporisation of the human prostate-immediate efficacy and 1-year follow-up[J]. Eur Urol,2007, 52(6):1717-1722.
[10] Wu G, Hong Z, Li C, et al.A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up[J]. Lasers Med Sci, 2016, 31(4):599-604.
[11] Wezel F, Wendt-Nordahl G, Huck N, et al.New alternatives for laser vaporization of the prostate: experimental evaluation of a 980-, 1,318- and 1,470-nm diode laser device[J]. World J Urol, 2010, 28(2):181-186.