经尿道120W绿激光前列腺汽化术与前列腺电切术疗效比较

A comparative study of clinical effects of 120W greenlight photoselective vaporization of prostate vs transurethral resection of prostate for treatment of benign prostatic hyperplasia

目的通过前瞻性随机对照实验比较经尿道120W绿激光前列腺汽化术与前列腺电切术的临床疗效。方法将38例BPH患者随机分为两组,分别行经尿道120W前列腺绿激光汽化术(120WPVP组,18例)和前列腺电切术(TURP组,20例),比较两组患者手术时间、术中出血、手术前后症状改善、术后膀胱冲洗时间、留置导尿管时间、住院时间及近期并发症。结果两组患者术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率和残余尿量均较术前明显改善(P<0.01),但两组上述指标间比较差异无显著性(P>0.05);120WPVP组术中出血、术后膀胱冲洗时间、留置导尿管时间、住院时间明显短于TURP组(P<0.05),而其手术时间明显长于TURP组(P<0.01);120WPVP组患者术后尿失禁、尿道狭窄、血尿、性功能障碍等并发症发生率明显低于TURP组(P<0.05)。结论120WPVP能有效治疗BPH,且与TURP具有相似的临床疗效,同时120WPVP相对于TURP具有操作安全、术中出血少、术后尿失禁、尿道狭窄等并发症少、恢复快等特点。

[ Objective] To evaluate the clinical effects of 120 W greenlight photoselective vaporization of prostate （120 W PVP） and transurethral resection of the prostate （TURP） for benign prostatic hyperplasia （BPH）by a prospective random control study. [Methods] A total of 38 BPH patients were randomly divided into two groups treated with either 120 W PVP （n =18） or TURP （n =20）. The perioperative markers and therapeutic results were recorded and analyzed. [Results] The IPSS, QOL, Qmax, PVR were greatly improved in both groups after operations （P〈0.01）, and the differences between these two groups were not significant （P 〉0.05）. The incidence of hemorrhage, the mean bladder irrigating time, catheterization time, hospital stay time were significant less or shorter in 120 W PVP group than in TURP group（P 〈0.05）. But the operating time was longer in 120 W PVP group than in TURP group （P〈0.01）. The incidences of complications such as uroclepsia, urethrostenosis, hematuria and impotence after operation in 120 W PVP group were lower than those in TURP group （P 〈0.05）. [ Conclusions] The therapy of 120 W PVP is safe and efficacious for BPH patients, with advantages of little blood loss, good tolerance＇and a few complications.