前列腺经尿道2微米激光和电切术临床疗效比较

A comparative study on clinical effect of two micron laser vaporesection of prostate and transurethral resection of the prostate during operation

目的:通过比较前列腺经尿道2微米激光和电切手术中可能出现的并发症,探讨前列腺2微米激光手术的安全性。方法:选择经尿道前列腺手术的患者50例,随机分为2微米激光组(A组)和电切手术组(B组),每组25例。常规监测BP、HR、SpO2和ECG,手术前和手术开始后60、90min及术后30、60min监测血Na+、血红蛋白(Hb)、红细胞压积(HCT)、中心静脉压(CVP);并记录出血量、手术时间、冲洗液总量、术中不良反应。结果:A组与B组术比较,手术时间较长,膀胱冲洗液用量大,但出血量少(P<0.05);B组血Na+、Hb、HCT下降、CVP升高,且寒战、躁动等不良反应多(P<0.05)。结论:与前列腺电切手术相比较,2微米激光手术中并发症少,安全性高。

Objective To evaluate the safety of 2 micron laser vaporesection of prostate by studying the complications compared to those of transurethral resection of the prostate （TURP）. Methods A total of 50 patients who were diagnosed with benign prostatic hyperplasia （BPH） were divided into two groups randomly, twenty-five cases of them underwent 2 micron laser vaporization resection （group A） and 25 cases for TURP （group B）. BP, HR, SpO2 and ECG were monitored. Blood Na＋, Hb, HCT and CVP were measured before operation, at 60 min, 90 min during operation, 30 min and 60 min after operation. Blood loss, operative time, bladder irrigation volume and all side-effects were reviewed retrospectively. Results The longer time of operation, more volume of irrigating fluid during operation and less blood loss in group A compared to those in group B （P 〈 0.05）. The blood levels of Na＋, HCT and Hb decreased significantly at 90 rain and postoperative period in group A compared with those before operation and at the same time in group B （P 〈 0.05）. CVP at 90 min in operation and 30 min after operation increased significantly in group A than those before operation and at the same time in group B （P 〈 0.05）. The side- effects such as restlessness and chest distress remarkably appeared during operation in group A compared with those in group B （P 〈 0.05）. Conclusion Compared to TURP, two micron laser vaporesection of prostate is a safe minimally invasive treatment for BPH with less complications.