激光在泌尿外科中的应用进展

The Development of Lasers in Urology

摘要: 激光的使用贯穿于现代泌尿外科始终，激光设备的使用也愈发普遍。随着科学技术的发展，人们一直在探索激光的更多应用。在众多设备中，钬激光、半导体激光和铥激光是目前使用最多的工具。根据激光的波长、水吸收度、血红蛋白吸收度和穿透深度不同，激光可以用来凝固、汽化和剜除。在许多医疗中心，经过众多药物治疗无效的良性前列腺增生，激光常常被用作它的主要治疗手段。并且和传统开放手术、经尿道电切手术相比，激光具有更好的治疗效果。激光在泌尿系结石、尿道(输尿管)狭窄和膀胱肿瘤中的应用，让伴有基础疾病的高龄患者的手术方案变得更加安全，同时减少抗凝药治疗方案改变的烦恼。激光手术更加微创化，缩短住院时长、减少保留尿管时间，有时甚至可以完全避免尿管的置入。而且，在术后并发症和二次手术率方面，激光也具有明显改善。总之，随着激光设备间竞争的激烈化，设备花费和维修费用的下降，手术安全性能的提高，激光将会成为泌尿外科领域不可或缺的设备。

Abstract: There has been a long time since the start of lasers in urology, and now it’s becoming more usual. With the development of science, people are exploring a new way. Among these devices available, holmium, diode and thulium lasers are the most popular. Lasers can be used for coagulation, vaporization and enucleation depending on the wavelength, the absorption by water and hemoglobin and the depth of penetration. Lasers play a key role when pharmacological treatment was useless for benign prostatic hyperplasia (BPH) patients in many medical centers. Compared with open or endoscopic operations, lasers have better therapeutic results. Treatment of older patient with multiple comorbidities has been made safe when lasers were used in the treatment of urolithiasis, urinary strictures and bladder tumors, and it can reduce the necessity to modify the anticoagulant drug treatment. Laser procedures are less invasive, shorter hospitalization time and guarantee a shorter bladder catheterization time, even eliminate the need for bladder catheterization completely. At the same time, it enables more stable outcomes and lower reoperation rate. However, with the increased competition between laser manufacturers, decreased purchase and maintenance costs, and increased operational safety, laser technology will become an indispensable tool in modern urology.