经尿道绿激光汽化术联合汽化电切术治疗重度前列腺增生的临床研究

The clinical study of greenlight photoselective vaporization of prostate joint transurethral electrovaporization resection of prostate in the treatment of severe benign prostatic hyperplasia

目的:评估经尿道前列腺选择性绿激光汽化术联合汽化电切术(PVP+TUVP)与经尿道前列腺汽化电切术(TUVP)治疗体积大于80ml重度BPH的安全性和临床疗效。方法:选取符合入选标准的重度BPH患者95例,按手术方式随机分为PVP+TUVP治疗组48例和TUVP对照组47例,比较两种术式的手术时间、术中出血量、术后血尿时间、症状评分、尿流动力学及并发症等指标。结果:PVP+TUVP组手术时间略长于TUVP组,但差异无统计学意义(P>0.10)。PVP+TUVP组术中出血量、术后血尿时间、并发症均少于TUVP组,差异有统计学意义(P<0.05)。术后随访12个月,PVP+TUVP组IPSS评分、QOL评分、Qmax、RUV均比术前明显改善(P<0.002),但组间比较差异无统计学意义(P>0.05)。结论:对于体积大于80ml重度BPH患者,PVP+TUVP比TUVP具有术中风险低、术后恢复快和并发症少等优点,临床疗效相似,是一种更加安全有效的微创手术方式。

Objective：To evaluate safety and clinical efficacy of greenlight photoselective vaporization of prostate joint transurethral electrovaporization resection of prostate （PVP ＋ TUVP） and transurethral electrovaporization resection of prostate （TUVP） treating volume greater than 80ml severe benign prostatic hyperplasia （BPH）. Methods：Selected met the inclusion criteria severe benign prostatic hyperplasia patients with 95 cases, according to surgical treatment were randomly divided into PVP ＋ TUVP group of 48 cases and TUVP control group of 47 patients, comparing two surgical operation time, blood loss, postoperative hematuria time, symptom score, urodynamic and complications indicators. Results： PVP ＋ TUVP operative time was slightly longer than TUVP group, but the difference was not statistically significant （P〉0. 10）. PVP ＋ TUVP group blood loss, postoperative hematuria time and complications are superior to TUVP group, the difference was statistically significant （P〈0.05）. Patients were followed up for 12 months, PVP ＋ TUVP group of international prostate symptom score （IPSS）, quality of life score （QOL）, maximum urinary flow rate （Qmax） and bladder residual urine （RUV） than before surgery significantly improved （P〈 0. 002）, but two of these indicators was no significant difference （P〉0.05）. Conclusions：For volumes greater than 80ml severe BPH patients, PVP＋TUVP than TUVP with low-risk surgery, rapid postoperative recovery and fewer complications, similar to clinical efficacy,it is a more safe and effective minimally invasive surgical approach.