120W半导体激光治疗良性前列腺增生的疗效分析

Clinical efficiency of 120W diode laser vaporization for benign prostate hyperplasia: report of 57 cases

摘要:

目的 探讨应用120W半导体激光治疗良性前列腺增生（BPH）的疗效和安全性。方法 选择年龄＞51岁、膀胱出口梗阻症状明显的57例BPH患者，应用120W半导体激光治疗。统计分析前列腺体积、手术时间及术前术后国际前列腺症状评分（IPSS）、最大尿流率（Qmax）及残余尿（PVR）的变化。结果 所有患者手术均获得成功，手术时间为（52.6±19.6）min。术前IPSS 15～32（24.7±4.4）分，术后下降到2～6（3.5±1.2）分；术前Qmax 0～12（6.7±3.4）ml/s，术后提高到（24.1±4.9）ml/s；术前PVR（77.2±45.7）ml，术后下降到（5.1±7.7）ml，差异有统计学意义。无死亡、输血、尿失禁、二次手术等病例。结论 120W半导体激光治疗BPH安全有效，但费用较高。

Abstract:

Objective To determine the clinical efficiency and safety of 120W diode laser vaporization in the treatment of benign prostatic hyperplasia (BPH). Methods A total of 57 patients [aged 50 to 89 (71.7±7.1) years] with obvious bladder outlet obstruction and diagnosed as BPH were included in the study. They were treated with the HPD Laser (120W/980nm Ceralas D120, Germany) in our department. Their operation time, the prostate volume, International Prostate Symptom Score (IPSS), maximum flow rate (Qmax) and post-void residual urine (PVR) before and after operation were measured and compared. Results The surgery was successfully performed to all of the patients within a duration of (52.6±19.6) min. Their IPSS was decreased from 24.7±4.4 (15 to 32) before surgery to 3.5±1.2 (2 to 6) after surgery surgery. Their Qmax was increased from (6.7±3.4) ml/s (0 to 12ml/s) before surgery to (24.0±4.9)ml/s (17.8 to 31.2ml/s) postoperatively, and PVR was reduced from (77.2±45.7) to (5.1±7.7) ml. Significant differences were seen in above indexes. No death, blood transfusion, urinary incontinence or secondary operation was observed in the cohort. Conclusion Diode laser of 980nm with output power up to 120W is safe and effective in prostate vaporization for BPH, but quite expensive.