经尿道绿激光气化术治疗前列腺增生的临床研究

Clinical effects of PVP on BPH

目的 对经尿道绿激光气化术（PVP）治疗前列腺增生的临床疗效进行研究。方法 选取前列腺增生并行PVP或经尿道前列腺电切术（TURP）患者，按1∶1比例分为PVP组45例和TURP组45例，回顾性分析患者手术相关情况和术后情况，并以电话或门诊随访的方式统计患者术后及术后36个月时的尿流率（Qmax）、膀胱残余尿量（RUV）、国际前列腺症状评分（IPSS）评分等相关情况。结果 PVP组手术时间略长于TURP组，但对比差异未见统计学意义（P〉0.05）；术中出血量、导管留置时间、住院时间以及术中并发症发生情况均低于TURP组（P〈0.05）；其中PVP组中出现并发症的2例患者拔管后出现短暂性排尿困难，24 h自行好转；TURP组中出现并发症的10例患者，3例于导管留置期间并发膀胱痉挛，7例轻度尿路刺激症状，经相应处理后均症状皆消失。术前两组患者Qmax、BRU、IPSS评分组间对比差异未见统计学意义（P〉0.05）；两组患者术后及术后36个月的Qmax、BRU、IPSS评分较同组术前比较，Qmax明显增加，BRU、IPSS评分显降低，对比差异有统计学意义（P〈0.05）；其中两组患者术后Qmax、BRU、IPSS评分组间对比差异未见统计学意义（P〉0.05）；术后36个月时，PVP组患者Qmax低于TURP组，RUV及IPSS评分均高于TURP组（P〈0.05）。结论 PVP较TURP安全性更佳，但对增生组织的清除效率不及TURP，临床还需依据患者实际情况选择合理的手术方式。

Objective To study the clinical curative effects of photoselective vaporization of prostate（PVP） on benign prostatichyperplas （BPH）.Methods Forty-five patients underwent PVP and 45 patients underwent TURP in hospital were selected as the study objects. They were named PVP group and TURP group with 45 case in each group. The patients’ related surgery condition and post-operative condition was retrospectively analyzed. The patients were followed-up and Qmax score, RUV score, IPSS score at 6 months after surgery and 36 months after surgery were observed by ways of phone call or outpatient follow-up.Results The surgery time in PVP group was slightly longer than that of TURP group, but the difference was not significant （P〉0.05）. The amount of bleeding during surgery, catheter dwell time, hospital stay length as well as the complication occurrence conditions in the PVP group were all lower than those of the TURP group（P〈0.05）. Two cases in the PVP group had complications and they had temporarily dysuresia after tube drawing. But both turned better automatically after 24 h. Ten cases in the TURP group had complications and 3 cases of them had cystospasm during the catheter dwell period, and the other 7 cases had slightly urinary irritation symptoms. However all the symptoms disappeared after the patients had been given related disposal. Meanwhile, the comparison of Qmax score, BRU score and IPSS scores of before surgery between both groups showed no significant difference （P〉0.05）. 36 months after surgery, Qmax score in the PVP group was lower than that in the TURP group. And the RUV score and IPSS score in the PVP group were all higher than those in the TURP group （P〈0.05）.Conclusions PVP is safer than TURP. However, the hyperplasia elimination efficiency by PVP is lower than that by TURP. Proper surgery method should be adopted according to the patients’ real clinical situation.