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題名 | Interstitial Laser Photocoagulation for Treatment of Benign Prostatic Hypertrophy: Outcomes and Cost Effectiveness=組織間質雷射凝固療法在良性攝護腺肥大症:治療效果及經濟效益 |
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作者姓名(中文) | 崔克宏; 張慧朗; 張世忠; 鄭鴻琳; | 書刊名 | 長庚醫學 |
卷期 | 26:11 2003.11[民92.11] |
頁次 | 頁799-806 |
分類號 | 416.275 |
關鍵詞 | 雷射; 攝護腺肥大症; 溫度調控; 阻塞; Benign prostatic hypertrophy; Laser; Temperature control; Obstruction; |
語文 | 英文(English) |
中文摘要 | 背景:評估組織間質雷射凝固療法在良性攝護腺肥大症之治療效果及經濟效益。 方法:自1997年10月至1998年1月間,有120位攝護腺肥大症之病人接受治療,其中60位病人是接受經尿道攝護腺切除術(TUR-P),另外60位的病人接受組織間質雷射凝固療法(ILC)。我們利用此兩組病人來評估,不同的手術治療方式,它們的臨床治療效果及經濟效益。 結果:在接受組織間質雷射凝固療法的病人,在臨床上、症狀都有顯著的改善。病人的攝護腺體積在手術之後12個月時,有減少26.8枴分(從46.6毫升縮小到34.4毫升)。同時、它與傳統的經尿道攝護腺切除術比較,無論在手術時間上,住院天數和術後止痛藥物的使用,都相對的減少(p<0.001)。夜是,組織間質雷射凝固療法的缺點是手術所使用的探頭設備,比一般經尿道攝護腺切除術昂貴。 結論:由於組織間質雷射凝固療法的併發症少,特別是逆行性射精的發生率遠低於接受經尿道攝護腺切除術之病人,所以,組織間質雷射凝固療法在攝護腺肥大症的治療上扮演者很重要的角色。特別是病人希震在術後保留正常的射精功能,或者是手術高危險群,且不適合接受經尿道攝護腺切除術者。組織間質雷射凝固療法乃提供另外一種選擇。 |
英文摘要 | Background: We examined the efficiency and cost effectivness of a temperature feedback diode-laser system in the treatment of benign prostatic hypertrophy (BPH). Methods: One hundred twenty patients with symptomatic BPH were included in this study between October 1997 and January 1998. Sixty of them were treated by transurethral October 1997 and January 1998. sixty of them were treated by transurethral resection of the prostate (TUR-P), and 60 patients were treated by temperature feedback interstitial laser coagulation (ILC). Direct and indirect cost parameters, such as operative tie, operation-related consumables, duration of hospitalization, and amount of medication used were compared between the 2 groups. Results: All subjective and objective urinary parameters exhibited significant improvement 12 months after ILC. A reduction of 26.8% (46.6 to 34.1 ml) of the pretreatment prostate volume was observed at 12 months following ILC. The duration of hospital stay, operative time, and postoperative medications were significantly lower for those receiving ILC (5.9 to 2.5 days, p<0.001) than for those who underwent TUR-P. The variety of laboratory tests needed for preoperative evaluation was no less when ILC was chosen for treating BPH (p=0.849). Indirect costs, such as investment in laser equipment and laser accessories were higher in the ILC group (p<0.001). Conclusion: The low morbidity profile, particularly the absence of retrograde ejaculation, makes ILC a valuable and attractive option for treatment of BPH patients who wish to retain their ejaculation ability, who have serious underlying diseases, or who have surgical risks for TUR-P or other invasive modalities. |
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