经尿道前列腺电切术与2μm激光前列腺汽化切除术治疗良性前列腺增生的效果比较

A comparative study of clinical effects of 2-micron laser vaporization resection of prostate versus transurethral resection of prostate for treatment of benign prostatic hyperplasia

目的通过前瞻性随机对照实验比较经尿道2μm激光前列腺汽化术与前列腺电切术的临床疗效。方法将60例良性前列腺增生（BPH）患者随机分为两组，分别行经尿道2μm激光前列腺汽化术（2-micronlaser组，30例）和前列腺电切术（TURP组，30例）。比较两组患者手术时间、术中出血量、手术后症状改善、术后膀胱冲洗时间、留置导尿管时间、住院时间及近期并发症。结果2-micronlaser组、TURP组患者术后国际前列腺症状评分（IPSS）[（6．6±1．8）分与（5．7±1．3）分]、最大尿流率[（20．6±1．5）ml／s与（19．5±1．7）ml／s]和残余尿量[（22．3±4．7）ml与（26．3±7．2）m1）均较术前明显改善[（33．2±2．2）、（33．4μ2．3）分，（7．8±4．3）、（8．3±4．5）ml／s，（57．2±10．5）、（60．2±14．5）ml，P值分别为0．005、0．008、0．036、0．001、0．005、0．013]，但术后两组上述指标间比较差异均无统计学意义（P值分别为0．16、0．49、0．97）；2-micronlaser组术中出血量[（20．9±12．1）m1]、术后膀胱冲洗时间[（1．0±0．5）d]、留置尿管时间[（3．2±1．3）d]、住院时间[（6．8±0．7）d]明显低于TURP组[（55．3±27．8）ml、（3．5±0．7）d、（6．0±1．5）d、（10．64-0．6）d，P值分别为0．009、0．005、0．035、0．03]。两组患者术后并发症发生率比较差异无统计学意义（P〉0．05）。结论2μm激光前列腺汽化术能有效治疗BPH，且与TURP具有相似的临床疗效，同时2μm激光前列腺汽化术相对于TURP具有操作安全，手术时间少、术中出血少，恢复快等特点。

Objective To investigate and compare the clinical effects of 2-micron laser vaporization resection of prostate （2-micron laser） and versus transurethral resection of prostate （TURP） for treatment of benign prostatic hyperplasia（BPH） in this prospective random control study. Methods Sixty patients of BPH were randomly divided into two groups including the 2-micron laser group （ n = 30） and the TURP group （ n = 30）. The perioperative markers and therapeutic results including duration of surgery, blood lose during surgery, improvement of symptoms after treatment, postoperative bladder washing time, the mean bladder irrigating time, hospital stay time, and recent complications were recorded and analyzed. Results The international prostate symptom score （ （6. 6 ± 1.8 ） vs. （ 33.2 ± 2. 2 ）, （5.7 ± 1.3 ） vs. （ 33.4 ± 2. 3 ） respectively）, maximal urinary flow（（20.6±1.5） ml/s vs. （7.8 ±4.3） m/s,（19.5 ± 1.7） ml/s vs. （8.3 ±4.5） ml/s respectively）, residual urine volume（（22.3 ±4.7） ml vs. （57.2 ± 10.5） m1,（26.3 ±7.2） ml vs. （60.2 ± 14.5） ml respectively） were significantly improved in both groups after operation （ P = 0. 005,0. 008,0. 036,0. 001, 0. 005,0. 013 respectively） , but the differences between these two groups were not significant （P = 0. 16,0. 49, 0. 97 respectively）. The volume of hemorrhage （ （ 20. 9 ± 12. 1 ） ml vs. （ 55.3 ± 27. 8 ） ml）, the mean bladder irrigating time （ （ 1.0 ± 0. 5 ） d vs. （ 3.5 ± 0.7 ） d）, cathererization time （ （ 3.2 ± 1.3 ） d vs. （ 6. 0 ± 1.5 ） d ）, hospital stay time （ （6. 8 ±0.7） d vs. （ 10. 6 ±0. 6） d） were significantly less or shorter in the 2-micron laser group than in the TURP group （ P = 0. 009, 0. 005,0. 035,0. 03 respectively ） . There was no significant difference in rates of complications between the two groups （ P 〉 0. 05 ）. Conclusion The therapy of 2-micron laser is safer and more efficacious than TURP for BPH patients, with advantages of short surgery duration, little blood loss, and quick recovery.