经尿道双频半导体激光前列腺剜除术与前列腺电切术治疗良性前列腺增生的疗效比较

A comparative study on the diode laser vaporization of the prostate and transurethral electrovaporization resection of prostate for the treat of benign prostatic hyperplasia

目的比较经尿道前列腺电切术与双频半导体激光剜除术治疗良性前列腺增生的临床疗效。方法回顾性研究2014年4月至2015年3月连云港市第二人民医院收治的119例诊断为良性前列腺增生患者,其中68例应用双频半导体激光汽化剜除治疗,51例采用经尿道前列腺切除术治疗,对两组患者平均手术时间、血红蛋白变化率、钠离子变化率、术后膀胱冲洗时间、留置导尿管时间进行比较;评估手术前后血清前列腺特异性抗原(PSA)、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿量(PVR)等,记录各组尿道狭窄、尿失禁、排尿刺激症状等术后并发症。结果双频半导体激光组与经尿道前列腺切除术组手术后血清PSA值[(1.2±0.8)μg/L、(1.1±0.7)μg/L]、IPSS评分(7.2±2.1、6.8±2.1)、PVR[(13.3±3.9)ml、(12.3±4.3)ml]、Qmax[(19.8±1.6)ml/s、(19.2±1.7)ml/s]等均较术前[(2.7±2.8)μg/L、(2.5±2.4)μg/L、21.7±2.1、22.1±1.9、(75.8±40.4)ml、(80.3±30.6)ml、(6.4±2.3)ml/s、(6.3±2.6)ml/s]明显改善(均P<0.05),但两组之间术后比较差异无统计学意义(P>0.05);双频半导体激光组与经尿道前列腺切除术组平均手术时间为(85.8±12.6)min、(83.4±14.8)min,差异无统计学意义(P>0.05);双频半导体激光组术中血红蛋白[(2.1±0.9)g/L]、钠离子变化幅度小[(5.1±1.4)mmol/L]、术后拔出导尿管早[(58.3±9.4)h]、膀胱冲洗时间短[(31.4±5.9)h],明显优于经尿道前列腺切除术组[(8.9±1.9)g/L、(14.8±2.5)mmol/L、(113.8±12.6)h、(76.8±8.7)h](均P<0.05)。术后随访6个月两组患者血清PSA值、IPSS、PVR、Qmax疗效无统计学差异。结论双频半导体激光可明显改善良性前列腺增生患者排尿症状,具有出血少、恢复快、并发症少、安全性高等特点,短期疗效与经尿道前列腺切除术疗效相近。

ObjectiveTo compare the therapeutic effects of the diode laser vaporization of prostate and transurethral electrovaporization resection of prostate.MethodsFrom April 2014 to March 2015, a total of 119 patients who were diagnosed with benign prostatic hyperplasia were divided into two groups: 68 patients were treated with diode laser and 51 patients were treated with TURP, all patients were followed up with operating time, the rate change of hemoglobin and sodium ions, postoperative bladder irrigation time, indwelling catheter time; assessing serum PSA values before and after surgery, IPSS score, PVR, Maximum flow rate, recording each group urethral stricture, urinary incontinence, irritative voiding symptoms and other complications.ResultsPSA, IPSS, PVR, Qmax were significantly improved after&nbsp;either of procedures (P<0.05), but with no significant differences between the two different procedure (P>0.05), mean operating time was (85.8±12.6)min for diode laser group and (83.4±14.8)min for TURP group, but with no significant differences between the two groups (P>0.05); the rate change of hemoglobin and sodium ions and postoperative bladder irrigation time, indwelling catheter time were all less for diode laser than TURP (P<0.05), patients of the two groups were of no significant difference in PSA, IPSS, PVR, Qmax after 6 months follows up (P<0.05).Conclusion The diode laser can significantly improve urinary symptoms of BPH, with less bleeding, faster recovery, fewer complications, higher safety efficacy and as efficacy as TURP in short-term.