Abstract:Objective: To explore the safety and efficacy of two micron laser vaporesection for benign prostatic hyperplasia with coagulation dysfunction. Methods: Respectively, 62 BPH patients with normal coagulation and 56 BPH patients with abnormal coagulation were treated with two micron laser vaporesection. The clinical data preoperation, intraoperation and postoperation were compared and analyed Results: There was no significant difference between the two groups in age, weight of prostate, Qmax and IPSS (P>0.05). In the two groups, no severe hemorrhage, transurethral resection syndrome and damage of rectum occurred. In the normal coagulation group, the mean time of operation was (69.1±12.0) min, the mean blood loss during operation was (62.5±8.9) mL, the mean time of bladder irrigating after operation was (9.0±1.7) h, the mean Qmax at 3rd month postoperation was (20.3±2.8) mL/s and the mean IPSS at 1st month postoperation was (7.2±1.3). In the abnormal coagulation group, the mean time of operation was (69.7±15.8) min, the mean blood loss during operation was (64.5±10.9) mL, the mean time of bladder irrigating after operation was (9.5±2.4) h, the mean Qmax at 3rd month postoperation was (19.7±2.6) mL/s and the mean IPSS at 3rd month postoperation was (7.7±3.3). There was no significant difference between the two groups in operation time, blood loss, bladder irrigating time, Qmax and IPSS (P>0.05). Conclusions: Two micron laser vaporesection of the prostate is a safe and effective treatment for BPH with coagulation dysfunction.
[1]杨勇,孙东翀,张旭,等.经尿道2μm激光分割式汽化切除术治疗良性前列腺增生.中华泌尿外科杂志,2009,30(11): 455-460. [2]胡湘,赵凯.常见抗凝药物对凝血功能的影响.中外健康文摘,2008,5(2):32-35. [3]黎金庆,周合冰,郭金成,等.血栓弹力图评价血小板ADP受体抑制率对血凝块形成的影响.血栓与止血学,2011,17(3): 121-123. [4]高元明.抗凝药物的合理应用.中国实用内科杂志, 2006, 26(12): 945-946. [5]Cheriachan D, Arianayagam M, Rashid P. Symptomatic urinary stone disease in pregnancy. Aust N Z J Obstet Gynaecol, 2008,48(1): 34-39. [6]Lifshitz DA, Lingeman JE, Lingeman JE. Ureteroscopy as a first-line intervention for ureteral calculi in pregnancy. J Endourol, 2002,16(1): 19-22. [7]Bozkurt Y, Soylemez H, Atar M, et al. Effectiveness and safety of ureteroscopy in pregnant women: a comparative study. Urolithiasis, 2013,41(3): 37-42. [8]Shih SJ, Dall'Era MA, Westphal JR, et al. Elements regulating angiogenesis and correlative microvessel density in benign hyperplastic and malignant prostate tissue. Prostate Cancer Prostatic Dis, 2003,6(2):131-137. [9]黎锋云,李春生,闵筠杰.经尿道前列腺电切术出血量的影响因素分析.临床医药实践杂志,2008,17(9): 856-859. [10]黄群,梁庆祖,黄键,等.前列腺电汽化术患者围手术期血液流变学研究.广西医科大学学报,2002,19(2): 200-201. [11]许勇,孙东翀,杨勇,等.2微米激光汽化切除术治疗良性前列腺增生症5年随访结果.中华外科杂志,2013,51(2): 1-4. [12]孙邕,罗光恒,孙兆林,等. 2μm激光汽化切除术与等离子双极电切术治疗良性前列腺增生的疗效比较.中国内镜杂志,2011,17(7): 687-691. [13]Bach T, Herrmann TR, Haecker A, et al. Thulium:yttrium-aluminium-garnet laser prostatectomy in men with refractory urinary retention. BJU Int, 2009,104(3): 361-364. [14]Bach T, Wendt-Nordahl G, Michel MS, et al. Feasibility and efficacy of thulium YAG laser enucleation (Vapo Enucleation) of the prostate. World J Urol, 2009,27(4): 541-545. [15]杨勇,洪宝发,魏志涛,等. 2μm激光分层汽化切割膀胱术治疗膀胱肿瘤.中华外科杂志,2008,46(18): 1410-1412. [16]杨勇,洪宝发,魏志涛,等.经尿道2μm激光前列腺汽化切除术治疗大体积良性前列腺增生的初步经验.中华泌尿外科杂志,2009,30(3): 198-201. [17]Yang Y, Wei ZT, Zhang X, et al. Transurethral partial cystectomy with continuous wave laser for bladder carcinoma. J Urol, 2009,182(1):66-69. [18]Fu WJ, Hong BF, Yang Y, et al. Two micron continuous wave laser vaporesection for the treatment of benign prostatic hyperplasia. Asian J Androl, 2008,10 (2): 341-342. [19]潘柏年.吴阶平泌尿外科.济南:山东科学技术出版社,2007: 1199-1224. [20] 张国银,姜彦飞,薛浩良,等.经尿道前列腺电切除术后并发症的防治.临床医学,2010,30(3): 73-74. [21]Sun DC, Yang Y, Wei ZT, et al. Transurethral dividing vaporesection for the treatment of large volume benign prostatic hyperplasia using 2 micron continuous wave laser. Chin Med J (Engl), 2010,123(17):2370-2374. [22] 刘春来,李宁,刘屹立,等.铥激光气化切除术与双极等离子电切术治疗良性前列腺增生的疗效比较.中国激光医学杂志,2011,20(2): 102-105. [23] 王振兴,孙兆林,刘军,等.2 微米激光与等离子治疗重度前列腺增生的对比研究(附50 例报告).贵州医药,2010,34(4): 319-321.