2μm激光汽化剜除前列腺增生的疗效和安全性分析

The Efficacy and Safety of 2 μm Laser Vapoenucleation of the Prostate

目的分析应用2μm激光汽化治疗前列腺增生的效果及安全性。方法用经尿道2μm激光前列腺汽化剜除术(ThuVEP组)、普通电切设备经尿道前列腺剜除术(TUEP组)治疗前列腺增生症(BPH)患者145例。观察并比较2组术中出血情况、冲洗液量、手术时间、术后膀胱冲洗时间、术后留置尿管时间、手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿(RUV)及并发症等。结果 2组患者年龄,术前病程、前列腺质量、IPSS评分、QOL评分、Qmax及RUV比较差异无统计学意义。2组手术均获得成功。ThuVEP组术中出血、术后冲洗时间、术后保留尿管时间等较TUEP组减少(P<0.05),且无术后并发症,TUEP术后并发症5例。术后随访3～12个月,2组患者IPSS、QOL、Qmax、RUV较术前明显改善(P<0.01),但组间比较差异无统计学意义。结论经尿道2μm激光汽化治疗前列腺增生症较传统TUEP更加安全有效,能明显改善前列腺增生患者的排尿症状及生活质量,且减少并发症的发生。

Objective To evaluate the safety and effectiveness of 2μm Thulium laser vaporization enucleation （Thu- VEP） in the treatment of benign prostate hyperplasia （BPH）. Methods A total of 145 patients with BPH were randomized into two groups including patients underwent ThuVEP and patients underwent standard transurethral resection of the pros- tate （TURP）. The intraoperative blood loss, flushing fluid quantity, operation time, bladder irrigating time, catheterization time, the international prostate symptom score （IPSS）, quality of life score （QOL）, the maximum flow rate （Qmax）, the post- void residual （PVR） and complications were observed in two groups. Results There were no significant differences in pa- tient age, preoperative duration, prostate weight, IPSS score,QOL score,Qmax and RUV between two groups. Patients in two groups were performed surgery successfully. The values of blood loss, bladder irrigating time and catheterization time were significantly less in ThuVEP group than those of TUEP group （P 〈 0.05）. There were no postoperative complications in pa- tients of ThuVEP group. There were 5 cases of complications in TUEP group after operation. The values of IPSS score,QOL score,Qmax and RUV were significantly different after 3-12-month follow up than those before operation （P 〈 0.01）, but no significant difference between two groups. Conclusion ThuVEP is a safe and more effective treatment than that of TURP for patients with BPH. ThuVEP can significantly improve the quality of life, and reduce complications in patients with BPH.