经尿道绿激光前列腺汽化术治疗良性前列腺增生症的有效性和安全性临床研究

Clinical study of efficacy and safety of transurethral photoselective laser vaporization for benign prostatic hyperplasia

目的评估绿激光前列腺汽化术(PVP)治疗良性前列腺增生症(BPH)的安全性和有效性。方法 2009年12月～2010年9月,72例BPH患者纳入该研究,按随机、单盲的方法入选PVP治疗组和经尿道前列腺等离子电切术(PKRP)对照组各36例,随访3个月。使用病例报告表记录术前、术中、术后1周及术后3个月的相关临床观察指标,包括最大尿流率、国际前列腺症状评分、生活质量评分、手术时间、术中失血量、冲洗液量、电解质等,并对上述数据进行统计学分析和评估。结果 13例因失访而剔除,余下PVP组30例及PKRP组29例进行统计学分析。两组患者的术前指标差异无显著性,术中冲洗液量、血电解质、住院时间、导尿管拔除时间、膀胱冲洗时间差异无显著性(P>0.05),但是PVP组手术时间长于PKRP组(P<0.05),PVP组术中失血量要显著少于PKRP组(P<0.05)。手术后两组患者排尿症状均得到显著的改善。PVP组和PKRP组分别有2例(7.40%)和3例(11.1%)发生尿道狭窄(P>0.05)。结论 PVP是治疗BPH的一种安全有效的方法,长期的效果需要进一步观察。

[Objective] To evaluate the safety and efficacy of transurethral photoselective laser vaporization of the prostate（PVP） for patients of benign prostatic hyperplasia（BPH）.[Methods] A randomized,single blind trail was done during the period of Dec.2009 to Sep.2010.72 patients of BPH were enrolled into the study and they were divided randomly into two groups.36 patients underwent PVP and the others underwent transurethral plasma kinetic resection of the prostate（PKRP）.Data of preoperative situations（age,medical history,deuteropathies,IPSS,QOL scores,sexual function and lab tests）,intraoperative situations（operation time,blood loss,irrigation volume and lab tests）,postoperative situations（irrigation time,catheterization time,medicine therapy,IPSS,QOL scores,urolfometry,complications and hospitalized time）,the results（urolfometry,IPSS,QOL scores and sexual function） of 3 months follow-up visit and adverse reaction were collected and analyzed.[Results] Six patients in PVP group and seven in PKRP group were loss of follow-up.For the rest of BPH patients,there was no significative difference between the data of preoperative situations.Meanwhile,no significative difference existed in the two groups on irrigation volume and serum electrolytes（P 0.05）.However,the blood loss of PVP group was less than that of PKRP group and operating time was shorter in the PKRP group（P 0.05）.Postoperative time of irrigation,catheterization and hospitalization of two groups were no significatively different（P 0.05）.Urinary symptoms of all patients were improved after surgery though 2 cases（7.40%） of urethral stricture were encountered in PVP groups and 3 cases（11.1%） in PKRP groups respectively（P 0.05）.[Conclusion] PVP is a safe and effective therapy for BPH and it seems to be safer compared with PKRP during the short-time follow-up,the long-time effect needs further observation.