目的：探讨2μm激光汽化术治疗晚期前列腺癌下尿路梗阻疗效。方法从2012年2月至2013年9月，我院采用2μm激光汽化术治疗晚期前列腺癌下尿路梗阻患者26例，术前评估准备、观察平均手术时间、血浆血红蛋白降低，术前、后国际前列腺症状评分（IPSS）、生活质量评分（QoL）、残余尿量（RUV）及最大尿流率（Qmax）变化等指标。结果26例患者手术成功，手术病人无输血，没有患者出现前列腺电切综合征。平均手术时间为（81.2±24.4）min，平均血红蛋白下降（6.4±3.2）g/L。术前PSA，IPSS，QoL，Qmax，RUV分别为（13.9±4.2）μg/mL,（23.6±4.1），（5.9±1.2），（7.3±2.3）mL/s，（147.3±55.4）mL。术后1个月随访 PSA，IPSS， QoL，Qmax，RUV变化，分别为（1.6±0.8）μg/mL，（8.8±2.9），（2.4±0.8），（15.8±3.6）mL/s，（40.6±19.3） mL。手术前后各项指标差异均有统计学意义（P＜0.01）。结论2μm激光汽化术针对治疗晚期前列腺癌下尿路梗阻是安全有效的微创手术方式。%Objective To explore the efficacy and safety of two micron continuous wave laser in the treatment of lower urinary tract obstruction caused by advanced prostate cancer.Methods Clinical data of 26 patients with lower urinary tract obstruction caused by advanced prostate cancer, who underwent two micron continuous wave laser, were analyzed retrospectively. The operative time, Hemoglobin decrease and operative complications was recorded. The variables such as PSA, IPSS, QoL, Qmax, post-void residual urine volume(RUV)were measured and analyzed before and after operations.Results All operations were performed successfully. None of patients received blood transfusion or had TURP syndrome. The mean operative time was 81.2±24.4 min, and the mean hemoglobin decrease was 6.4±3.2 g/L. The pre-operative levels of PSA, IPSS, QoL, Qmax, RUV were 13.9±4.2μg/mL, 23.6±4.1, 5.9±1.2, 7.3±2.3 mL/s and 147.3± 55.4 mL,respectively, and postoperative levels of PSA, IPSS, QoL, Qmax and RUV were 1.6±0.8μg/mL, 8.8±2.9, 2.4±0.8, 15.8±3.6 and 40.6±19.3. There were significant differences in above parameters between before operation and after operation(P<0.01). Few complications were found and good outcomes of operation was for all treated patients. Conclusion The two micron continuous wave laser may be a safe, efficient and minimal invasive treatment therapeutic option for lower urinary tract obstruction caused by advanced prostate cancer.
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