红激光联合坦洛新治疗前列腺增生的疗效分析

Analysis of the curative effect of red laser combined with tamsulosin in the treatment of prostatic hyperplasia

目的观察采用980mm半导体红激光汽化术联合坦洛新治疗前列腺增生的临床效果。方法选取76例前列腺增生患者作为研究对象,按就诊顺序编号,随机分为对照组与观察组各38例。对照组采用常规经尿道前列腺电切术(TURP)治疗,观察组采用红激光经尿道前列腺汽化术治疗,两组术后均采用坦洛新干预,比较两组术后前列腺症状评分(IPSS)改善情况,记录手术前后患者生活质量(QOl)评分差异,统计两组残余尿量(PVR)、最大尿流率(Qmax)及术后并发症发生率。结果 (1)观察组手术时间(70.34±16.78)min长于对照组(56.44±17.58)min,且术中输血量、术中冲洗液用量(25.36±4.78)ml、(45.32±14.21)ml)均少于对照组的(19.84±4.33)ml、(96.48±23.69)ml)(P<0.05)。(2)观察组膀胱冲洗时间、留置尿管时间、住院时间(14.36±6.78)h、(4.56±1.39)d、(3.64±1.11)d均短于对照组的(46.67±11.23)h、(5.97±0.26)d、(5.44±1.26)d(P<0.05)。(3)术后两组PVR均明显降低,Qmax均明显上升(P>0.05)。(4)术后3、6个月两组患者QOl、IPSS评分均明显改善(P<0.05),但组间对比差异无统计学意义(P>0.05)。(5)观察组术后并发症发生率(10.53%)明显低于对照组(31.58%),两组对比差异有统计学意义(P<0.05)。结论在前列腺增生患者的临床治疗中采用980nm半导体红激光汽化术联合坦洛新方案,可降低患者术中出血量、缩短住院时间、降低并发症发生率、改善患者前列腺症状,可在临床推广应用。

Objective To observe the clinical effect of red laser combined with tamsulosin in the treatment of prostatic hyperplasia. Methods 76 patients with prostatic hyperplasia were selected as the research objects. According to the order of treatment, the patients were divided into the control group and the observation group, 38 cases in each group. The control group was treated by routine transurethral resection of prostate （TURP） while the observation group was treated by red laser transurethral vaporization of the prostate. After surgery, the two groups were given tamsulosin intervention. The improvement of international prostate symptom scores （IPSS） in the two groups after surgery was compared. The differences in quality of life （QOL） scores before and after surgery were recorded. The post-void residual volume （PVR）, maximum flow rate of urine （Qmax） and the incidence rates of postoperative complications in the two groups were statistically analyzed. Results The operation time of the observation group [（70.34± 16.78） mini was longer than that of the control group [（56.44± 17.58） mini. The volume of intraoperative blood transfusion and the dosage of intraoperative irrigating liquid of the observation group[（25.36±4.78） ml, （45.32± 14.21） ml）] were less than those of the control group [（19.84±4.33） ml, （96.48±23.69） ml）] （P〈0.05）. The time of bladder washing, indwelling urinary catheter and the length of hospital stays of the observation group [（14.36±6.78） h, （4.56±1.39） d, （3.64±1.11） d]was shorter than that of the control group [（46.67±11.23） h,（5. 97±0. 26） d,（5. 44±1. 26） d] （P〈0.05）. PVR in the two groups decreased significantly while Qmax increased significantly （P〉 0.05）. 3 month and 6 months after surgery, QOL and IPSS scores in the two groups were significantly improved （P〈0.05）. The incidence rate of postoperative complications in the observation group （10.53%） was significantly lower than that in the control group （31.58%） （P〈0.05）. Conclusion To adopt 980nm semiconductor red laser vaporization combined with tamsulosin in the clinical treatment of patients with prostatic hyperplasia can reduce intraoperative blood loss, shorten hospitalization time, reduce the incidence of complications and improve the symptoms of prostate.