1 470 nm半导体激光减容性切除治疗高危前列腺增生的临床研究

doi:10.3877/cma.j.issn.1674-3253.2024.05.005

目的

探讨1 470 nm半导体激光（简称1 470 nm激光）三叶法减容性切除治疗高危前列腺增生（BPH）的安全性和疗效。

方法

回顾性分析2019年4月至2022年10月中国人民解放军中部战区总医院收治的行1 470 nm激光三叶法，即行前列腺中叶及两侧叶增生腺体块状切除治疗113例高龄高危BPH患者的临床资料。统计患者的一般情况、手术时长、留置导尿时间等，比较手术前后IPSS评分、残余尿量、尿流率等指标。

结果

所有患者均顺利完成手术，术中、术后均未输血。手术时间、血红蛋白下降值、膀胱冲洗时间、留置导尿管时间及住院时间分别为（41.6±15.3）min，（1.1±0.8）g/L，（1.3±0.2）d，（1.7±0.3）d和（5.5±1.2）d。109例患者术后IPSS评分、QOL评分、RUV及Q_max显著优于术前（P<0.05）。4例术后排尿改善不明显，均为前列腺体积<40 ml。

结论

1 470 nm激光三叶法减容性切除治疗高危BPH具有创伤小、出血少、恢复快、疗效好等优势，适合前列腺体积较大高龄高危BPH患者。

关键词: 前列腺增生, 高龄高危, 1 470 nm激光, 人口老龄化, 三叶法切除, 减容性

Objective

To evaluate the safety and efficacy of 1 470 nm laser tri-lobe resection in the treatment of high-risk benign prostatic hyperplasia (BPH) with reduced volume excision.

Methods

The clinical data of 113 patients with high-risk BPH treated by the 1 470 nm laser tri-lobe resection, that is, the mass resection of the middle and bilateral hyperplasia glands of the prostate, were reviewed and analyzed from April 2019 to October 2022. The patient's general condition, operation duration, indwelling catheterization time, etc. were analyzed, and the preoperative and postoperative IPSS score, residual urine output (RUV), urine flow rate (Q_max) and other indicators were compared.

Results

All patients were completed the operation successfully. There was no intraoperative or postoperative blood transfusion. Operation time, decreased value of hemoglobin, bladder irrigation time, indwelling catheter time and hospitalization time were (41.6±15.3) min, (1.1±0.8) g/L, (1.3±0.2) d, (1.7±0.3) d and (5.5±1.2) d respectively. The postoperative IPSS score, QOL score, RUV and Q_max score of 109 cases were significantly better than those before operation (P<0.05). The improvement of urination was not obvious in 4 cases, whose prostate volume were <40 ml.

Conclusions

1 470 nm laser tri-lobe resection has the advantages of minimal trauma, less bleeding, rapid recovery, good efficacy and other advantages. It's suitable for elderly high-risk BPH patients with large prostate volume.

Key words: Benign prostatic hyperplasia (BPH), Elderly high-risk, 1 470 nm laser, Population aging, Tri-lobe resection, Reduced volume excision

表1 113例BPH患者术前与术后3个月指标比较（

±s）

组别	IPSS评分(分)	QOL评分(分)	RUV(ml)	Q_max(ml/s)
术前	24.2±3.1	4.3±1.5	91±35	6.1±3.6
术后	6.5±1.3	2.2±0.7	31±14	16.8±1.7
t值	13.627	7.527	6.392	8.341
P值	<0.001	<0.001	<0.001	<0.001

表1 113例BPH患者术前与术后3个月指标比较（

±s）

组别	IPSS评分(分)	QOL评分(分)	RUV(ml)	Q_max(ml/s)
术前	24.2±3.1	4.3±1.5	91±35	6.1±3.6
术后	6.5±1.3	2.2±0.7	31±14	16.8±1.7
t值	13.627	7.527	6.392	8.341
P值	<0.001	<0.001	<0.001	<0.001

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Clinical study of 1 470 nm semiconductor laser volume reduction excision of high-risk benign prostatic hyperplasia

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Clinical study of 1 470 nm semiconductor laser volume reduction excision of high-risk benign prostatic hyperplasia