经尿道直出绿激光汽化切除术治疗良性前列腺增生的效果

Effect of photoselective vaporesection of the prostate on benign prostatic hyperplasia

目的探讨经尿道直出绿激光汽化切除术(PVRP)治疗良性前列腺增生(BPH)的效果。方法选取郑州人民医院2019年10月至2020年12月接收的BPH患者80例为研究对象,依据双盲法分成观察组与对照组,每组40例。观察组采用PVRP治疗,对照组采用经尿道前列腺电切术(TURP)治疗。比较两组围术期指标(术后膀胱冲洗时间、术中出血量、留置导尿管时间)。比较术前、术后6个月两组前列腺症状[依据国际前列腺症状评分表(IPSS)评估];随访6个月,记录患者并发症发生情况(术后出血、尿失禁、尿道狭窄)。结果观察组留置导尿管时间和术后膀胱冲洗时间均比对照组短,术中出血量少于对照组,差异有统计学意义(P<0.05)。跟术前IPSS评分比较,两组术后6个月评分显著降低,且观察组变化更大(P<0.05)。两组随访期间并发症发生率比较,观察组较对照组低(P<0.05)。结论与TURP比较,PVRP治疗BPH患者可缓解前列腺症状,术中出血量较少,术后膀胱冲洗及留置导尿管时间均较短,且安全性尚可。

Objective To investigate the effect of photoselective vaporesection of the prostate(PVRP)on benign prostatic hyperplasia(BPH).Methods A total of 80 patients with BPH from October 2019 to December 2020 in People’s Hospital of Zhengzhou were selected and divided into the observation group and the control group according to the double blind method,with 40 cases in each group.The observation group was treated with PVRP,and the control group was treated with transurethral resection of prostate(TURP).Perioperative indexes(postoperative bladder flushing time,intraoperative bleeding volume,indwelling catheter time)were compared between the two groups.The prostate symptoms of the two groups[evaluated according to the International Prostate Symptom Scale(IPSS)]were compared before and 6 months after operation.The patients were followed up for 6 months to record their complications(postoperative bleeding,urinary incontinence,urethral stricture).Results The indwelling catheter time and postoperative bladder flushing time in the observation group were shorter than those in the control group,and the intraoperative bleeding volume was less than that in the control group,the differences were significant(P<0.05).Compared with the IPSS score before operation,the score in the two groups decreased significantly 6 months after operation,and the change in the observation group was greater(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusions Compared with TURP,PVRP can relieve prostate symptoms in BPH patients,with less intraoperative bleeding,shorter postoperative bladder flushing and catheter indwelling time,and is safe.