经尿道直出绿激光推铲式汽切术与双极等离子电切术治疗高龄高危BPH的对比研究

Comparative study between transurethral end-fire greenlight photoselective vaporesection of prostate-shovel technique and transurethral bipolar plasmakinetic resection prostatectomy for the treatment of the elderly and high-risk BPH patients

目的:比较经尿道直出绿激光前列腺推铲式汽切术(PVRP-ST)与经尿道前列腺双极等离子电切术(TUPKRP)治疗高龄高危BPH的效果和安全性。方法:将64例高龄高危BPH患者随机分为两组,PVRP-ST组32例,TUPKRP组32例。比较分析两组患者术中及术后的相关临床指标。结果:所有患者手术均成功,无严重并发症发生。PVRP-ST组平均手术时间(71.9±23.3)min与TUPKRP组平均手术时间(60.0±24.1)min比较差异无统计学意义(P>0.05)。PVRP-ST组平均出血量(24.3±2.1)ml小于TUPKRP组平均出血量(45.1±9.4)ml;两组间比较差异有统计学意义(P<0.05)。PVRP-ST组和TUPKRP组术后3个月Q_(max)、RUV、IPSS、QOL均明显改善,与术前比较差异均有显著统计学意义(P<0.01)。两组组间比较,上述指标间差异均无统计学意义(P>0.05)。结论:PVRP-ST治疗高龄高危BPH安全、有效,在出血控制上较TUPKRP更有优势。

Objective：To compare the safety and efficacy between transurethral end-fire greenlight photoselective vaporesection of prostate-shovel technique（PVRP-ST）and transurethral bipolar plasmakinetic resection prostatectomy（TUPKRP）for high-risk and elderly patients with BPH.Method：A total of 64high-risk and elderly patients with BPH were enrolled.PVRP-ST（32cases）and TUPKRP（32cases）were performed respectively.The clinical data were compared between the two surgical groups.Result：All the operations were successfully completed and no severe complication was observed.No significant difference was found in mean operative time between PVRP-ST group（71.9±23.3）min and TUPKRP group（60.0±24.1）min.The volume of blood loss in PVRP-ST group（24.3±2.1）ml was less than that in TUPKRP group（45.1±9.4）ml（P〈0.05）.Q max,RUV,IPSS and QOL scores decreased significantly three months after the operation in both groups.Significant difference of these parameters was found postoperatively（P〈0.05）.There was no significant difference of these data between the two groups（P〉0.05）.Conclusion：Transurethral end-fire PVRP-ST is a safe and effective procedure for high-risk and elderly patients with BPH.Better blood loss control can be found in PVRP-ST group compared with that in TUPKRP group.