450nm 半导体蓝激光前列腺汽化切除术治疗不停用抗凝药高危良性前列腺增生患者初探

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semiconductor blue laser vaporization prostatectomy in the treatment of high-risk benign prostatic hyperplasia patients without discontinuing anticoagulant drugs

WU Yongdi，SUN Jiaqing，CHAO Liang，ZHOU Chen，QIU Dong，SHI Pengfei （Department of Urology，The Third Afiliated Hospital of Xuzhou Medical University，Xuzhou 221003，China

ABSTRACT：Objective To evaluate the efficacy and safety of 450nm semiconductor blue laser vaporization prostatectomy inhigh-risk benign prostatic hyperplasia（BPH）patientswithout discontinuinganticoagulant drugs，soas toprovideasafeand effective minimally invasive treatment option forsuchpatients.MethodsAtotal of 4O high-risk BPH patients who underwent 450nm semiconductor blue laser vaporization prostatectomy in our hospital during Sep. 2O23 and Dec.2024 were selectedas theresearchsubjects.Thepatients weredividedintotwogroups：theoralmedicationgrouptookoralanticoagulants duringteperioperative period，hilethediscontinuationgroupdiscontinuedanticoagulants，with 2Ocases ineither group.The perioperative indicatorsandchanges including international prostate symptomscore（IPSS），qualityof life score（QoL）， maximumurinary flow rate（Qmax）and post-void residual（PVR）were compared between the two groups.ResultsThere were no statisticallysignificantdiferences betwen theoral medicationgroupand discontiuation group inoperatio time （28.83±15.52 ）minvs. （26.43±14.02）min] ，postoperative catheter indwelling time [（3.04±0.89） dvs. （3.23±1.01） d]， bladder irrigationtime [（27.36±7.54） hvs. （25.46±7.10）h] ，and decrease in hemoglobin ， （7.56± 1.68）g/L] （all P>0.05 ）.Three month after surgery，Qmax in both groups was higher，while IPSs，QoL and PVR were significantly lower （ P<0.05） ，but there were no statistically significant differences between the two groups （ P>0.05; .No serious complications such as urinary incontinence or massive hemorrhage occurred. Conclusion 450nm semiconductor blue laservaporization prostatectomy forhigh-risk BPH patients ischaracterizedbyhigh vaporization ficiencyandgood hemostaticeffects.Itcansignificantlyimprovetheclinicalsymptoms withhighsafety，especiallforhigh-riskpatientswho cannot discontinue anticoagulants.

KEY WORDS ： benign prostatic hyperplasia; 450nm semiconductor blue laser;anticoagulant drugs; vaporization prostatectomy摘要：目的分析 450nm 半导体蓝激光前列腺汽化切除术在不停用抗凝药物的高危良性前列腺增生（BPH）患者治疗中应用的疗效及安全性，以期为此类患者提供安全有效的微创治疗方案。（剩余6587字）