经尿道绿激光前列腺汽化术治疗BPH的疗效观察

Curative effect of the transurethral greenlight laser vaporization of the prostate for benign prostatic hyperplasia

目的:与经尿道前列腺等离子电切术(PKRP)进行对比研究,评估绿激光前列腺汽化术(PVP)治疗BPH的有效性和安全性。方法:2009年12月～2010年9月收治BPH患者70例,随机单盲分为两组,其中PVP组35例(研究组),PKRP组35例(对照组)。出院后3个月返院由专人负责复查,记录术前和出院后3个月的临床观察指标,包括国际前列腺症状评分(IPSS)、生活质量指数(QOL)、最大尿流率(Qmax)、男性性功能四项(MSF-4)以及并发症,采用SPSS13.0统计软件对上述资料进行统计学分析和评估。结果:两组患者术前指标、手术时间、术中冲洗液量、实验室检查、住院时间、导尿管拔除时间、膀胱冲洗时间差异无统计学意义(P>0.05)。出院后3个月,两组患者IPSS、QOL、Qmax均得到显著改善,MSF-4与术前相比差异无统计学意义。PVP组和PKRP组分别有2例(7.0%)和3例(10.0%)术后发生前尿道狭窄,发病率差异无统计学意义(P>0.05)。两组均未出现尿失禁。结论:PVP是一种治疗BPH的安全、有效的方法,短期(3个月内)疗效及安全性与PKRP类似,长期疗效有待随后进一步评估。

Objective：To evaluate the efficacy and safety of greenlight laser vaporization of the prostate（PVP） by comparing it with transurethral plasmakinetic resection of the prostate（PKRP） for benign prostatic hyperplasia. Methods：Among the patients with BPH treated in our hospital from Dec. 2009 to Sep. 2010, 70 cases were included in our study. A randomized, single blind trail was performed to divide all cases into two groups. Thirty-five patients were assigned into PVP group （experimental group）, and the other thirty five patients were in PKRP group （control group）. All the patients returned to our hospital and underwent reexamination which is administered by especially appointed staff at the third month after hospital discharge. We documented the clinical data of pre-operation, hospital discharge and 3 months later by means of the case report form with items of international prostate symptom score（IPSS）, quality of life（QOL）, male sexual function 4-item（MSF-4）, and complications etc. All statistical analyses and assessment were performed with SPSS software （version 13.0）. Results： There was no significant difference between the two groups in the data of preoperative situations, operation time, irrigation volume, lab tests, hospital stays, catheterization time and irrigation time （P〉0.05）. IPSS, QOL, Q Qave in both groups were remarkably improved. There were 2 cases of anterior urethral strictures （7.0%） in PVP group and 3 cases （10.0%） in PKRP group respectively （P〉0.05）. There were no changes of sexual function before and after surgeries of all patients. Conclusions： PVP is a safe and efficient operative procedure for BPH, prior to PKRP smilar in short-term （within three months） safety and efficacy. The long-term validity is necessary to be evaluated forward.