铥激光与绿激光治疗80g以上高龄高危BPH的疗效比较

Greenlight photoselective vaporization prostatectomy versus thulium laser vaporesection of the prostate for aged high-risk BPH patients with the prostate heavier than 80g

目的:比较经尿道选择性绿激光前列腺汽化术(PVP)与经尿道铥(2微米)激光前列腺汽化切除术(TmLRP)治疗80 g以上高龄高危良性前列腺增生(BPH)的疗效。方法:分别用PVP及TmLRP治疗80 g以上高龄BPH患者各82例、36例。比较两种术式的手术时间、费用、术中失血量,并发症及近期疗效等指标。结果:118例均安全度过围手术期,未出现严重并发症,未输血。TmLRP组的平均手术时间、术后膀胱冲洗时间及手术费用均明显少于PVP组(P<0.05)。两组术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)及最大尿流率(Qm ax)均明显改善(P(0.05),但两组间改善程度无明显差别(P(0.05)。结论:PVP与TmLRP治疗80 g以上高龄高危BPH安全有效,TmLRP在手术时间及费用方面优于PVP。

Objective： To compare the effects of greenlight photoselective vaporization prostatectomy（PVP） and thulium laser vaporesection of the prostate（TmLRP） in the treatment of aged high-risk BPH patients with the prostate weighing 80 g.Methods： We included in this study 118 high-risk BPH patients aged 62-96（mean 76） years with the prostate heavier than 80 g,82 treated by PVP and the other 36 by TmLRP.Then we compared the operation time,intraoperative bleeding,complications,short-term effectiveness,and surgical cost between the two groups.Results： All the patients tided over the perioperative period without blood transfusion and serious complications.The mean operation time,postoperative bladder irrigation time and surgical cost were significantly less in the TmLRP than in the PVP group（P0.05）.Both the procedures remarkably improved the international prostatic symptom score（IPSS）,quality of life（QOL）,post void residual urine（PVR） and Qmax of the patients（P0.05）,but with no significant differences between the two groups（P0.05）.Conclusion： Both PVP and TmLRP are effective and safe for the treatment of aged high-risk BPH patients with the prostate heavier than 80 g,but the latter is superior for its shorter operation time and lower surgical cost.