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中华腔镜泌尿外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 166 -170. doi: 10.3877/cma.j.issn.1674-3253.2020.03.002

所属专题: 文献

临床研究

层面递进法激光腔内剜除高危前列腺增生的治疗体会
罗保华1, 李名钊2, 王华2, 冯华聪2, 谢耀东2, 刘小彭2,()   
  1. 1. 5180552 深圳,南方科技大学医院泌尿外科
    2. 510630 广州,中山大学附属第三医院泌尿外科
  • 收稿日期:2018-12-18 出版日期:2020-06-01
  • 通信作者: 刘小彭
  • 基金资助:
    广州市天河区科技计划项目医疗联合体项目(2018)

Experiences in the treatment of high-risk prostatic hyperplasia by laser intracavitary extirpation with hierarchical method

Baohua Luo1, Mingzhao Li2, Hua Wang2, Huacong Feng2, Yaodong Xie2, Xiaopeng Liu2,()   

  1. 1. Department of Urology, Hospital of Southern Univeristy of Science and Technology, Shenzhen 518055, China
    2. Department of Urology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
  • Received:2018-12-18 Published:2020-06-01
  • Corresponding author: Xiaopeng Liu
  • About author:
    Corresponding author: Liu Xiaopeng, Email:
引用本文:

罗保华, 李名钊, 王华, 冯华聪, 谢耀东, 刘小彭. 层面递进法激光腔内剜除高危前列腺增生的治疗体会[J]. 中华腔镜泌尿外科杂志(电子版), 2020, 14(03): 166-170.

Baohua Luo, Mingzhao Li, Hua Wang, Huacong Feng, Yaodong Xie, Xiaopeng Liu. Experiences in the treatment of high-risk prostatic hyperplasia by laser intracavitary extirpation with hierarchical method[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(03): 166-170.

目的

探讨1 470 nm激光剜除治疗高危前列腺增生的手术技巧及临床效果。

方法

回顾分析2018年6月至2018年9月中山大学附属第三医院泌尿外科采用1 470 nm激光治疗共89例高危前列腺增生患者的临床资料,年龄平均(68±3)岁,前列腺体积(57.4±2.6)ml。所有患者均采用"寻找层面,先易后难,剜切结合"的层面递进法思路行激光腔内前列腺剜除术,比较患者术中及术后情况。

结果

89例均顺利完成手术,与术前相比,术后3个月患者最大尿流率明显增加,[(6.9±2.1) ml/s vs(19.8±3.6) ml/s]。国际前列腺症状评分显著好转,[(24.6±1.7) vs(8.0±1.2)]。术中无输血、无电切综合征、无直肠和膀胱穿孔病例,无输尿管损伤、大出血、心脑血管意外等严重并发症发生。

结论

层面递进法激光剜除技术构想对于高危前列腺增生外科包膜层面的寻找、减少术后并发症有独到优势,且易于掌握,或可为业界同行提供一个新的思路。

Objective

To investigate and evaluate the clinical effect and safety of intracavitary laser surgery with the hierarchical technique for high-risk prostate hyperplasia patients.

Methods

The modified surgery was performed on 89 cases of high risk prostate hyperplasia patients in the Third Affiliated Hospital of Sun Yet-Sen University. All the clinical data were analyzed retrospectively, The average age of the patient was (68±3) years, the average prostate volume was (57.4 ±2.6) ml. All patients underwent laser intracavitary prostate enucleation with the hierarchical approach, which is "Look for layers, easy first, difficult later, resect and enucleate", and their intraoperative and postoperative conditions were compared.

Results

All 89 procedures were performed successfully. The maximum urine flow rate (Qmax) were improved from (6.9±2.1) ml/s to (19.8±3.6) ml/s, and the international prostate symptom score (IPSS) were significantly decreased from (24.6±1.7) to (8.0±1.2), 3 months after surgery. No patient required transfusion. Transurethral resection syndrome, rectum and bladder perforation, and ureteral injury, massive bleeding, cardiovascular and cerebrovascular accidents and other serious complications were not occurred during the operation.

Conclusion

The laser exorsion surgery with hierarchical method has unique advantages in finding the capsule level and reducing postoperative complications of high-risk prostatic hyperplasia. It is easy to grasp and may provide a new method for colleagues.

表1 89例高危前列腺增生患者术前伴随症状及基础疾病分布情况
图1 层面递进法激光腔内剜除高危前列腺增生的手术步骤
表2 89例高危前列腺增生患者的临床资料
表3 患者手术前后评分比较(±s)
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