钬激光用于良性前列腺增生的治疗进展

陈昊 董自强

[摘要] 良性前列腺增生（Benign prostatic hyperplasia，BPH）是中老年男性常见病、多发病，临床症状以排尿困难、膀胱刺激症状为主，病情进一步发展时，患者会出现尿潴留、肾积水等严重并发症，严重影响患者的生活质量，此时，患者需接受以手术为主的综合干预措施。伴随钬激光技术在泌尿外科领域的大力推广，经尿道钬激光剜除良性前列腺增生的手术方式越来越炙热化，自2016年起，就已被欧洲泌尿外科指南予以推荐。笔者就近年来钬激光技术应用于BPH的相关原理、发展史、现状及发展前景做一综述。

[关键词] 良性前列腺增生;钬激光;临床治疗;经尿道钬激光前列腺增生剜除术;经尿道前列腺电切术

[中图分类号] R697.3          [文献标识码] A          [文章编号] 1673-9701（2021）30-0188-05

[Abstract] Benign prostatic hyperplasia （BPH） is a common and frequently occurring disease in middle-aged and elderly men. The clinical symptoms are mainly dysuria and bladder irritation. When the condition further develops， patients will have serious complications such as urinary retention and hydronephrosis， which severely affect patients′ quality of life. The patient needs to receive comprehensive interventions with surgery as the mainstay. With the vigorous promotion of holmium laser technology in the field of urology， the surgical method of transurethral holmium laser enucleation of benign prostatic hyperplasia has become more and more popular. Since 2016， it has been recommended by the European Urology Guidelines. The author summarizes the relevant principles， development history， status quo， and development prospects of applying holmium laser technology to BPH in recent years.

[Key words] Benign prostatic hyperplasia; Holmium laser; Clinical treatment; Transurethral holmium laser enucleation of prostatic hyperplasia; Transurethral resection of the prostate

良性前列腺增生是引起中老年男性排尿障碍最为常见的疾病之一，其发病率随着社会老龄化，也在不断上升，严重影响患者的身心健康[1-4]。在临床上，治疗BPH的方式主要包括观察等待、药物治疗及手术治疗[5]。在这之中，手术方式从早期开放前列腺摘除术向经尿道前列腺电切术过渡，进一步发展至经尿道剜除术，其中，伴随科学技术的不断进步，操作器械及能量平台的不断更新，经尿道手术的具体术式也在不断发生蝶变。普通电切、等离子电切方式全面普及的同时，以激光为主要能量媒介的手术方式诞生并凸显出它的优势，而钬激光就是其中重要一员。

1 钬激光

钬激光是一种脉冲激光，利用同时结合有二氧化碳与钕：钇铝石榴石激光器的一种固体介质，同时进行组织切割和烧灼，其波长可通过光纤传输[6]。……