经尿道前列腺1470nm激化术与经尿道前列腺电切术治疗良性前列腺增生的疗效比较

Comparison of the efficacy and safety between 1470nm laser photoselective vaporization of prostate and transurethral resection of prostate for the treatment of benign prostatic hyperplasia

目的探讨经尿道前列腺1470nm激光汽化术与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的临床疗效。方法选取2013年1月至2016年1月在本院行TURP或1470nm激光汽化术的良性前列腺增生患者186例,其中114例行TURP手术,72例行1470nm激光汽化术,术前测定PSA、前列腺体积、最大尿流率(Qmax)、残余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL);收集手术时间、术中出血量、并发症发生率等;并于术后3、6个月随访,对两组患者的资料进行对比,评价其临床疗效。结果两组患者在年龄、前列腺体积、PSA、合并症、IPSS、QOL、Qmax、PVR比较差异无统计学意义(P>0.05);而1470nm激光汽化组在手术时间、术中出血量、术后下床活动时间、术后留置尿管时间及术后住院时间均明显优于TURP组,两组比较差异有统计学意义(P<0.01);但两组患者在并发症发生率和术后疗效比较差异无统计学意义(P>0.05)。结论1470nm激光汽化术与TURP相比,具有相同的临床疗效,但具有手术时间短、术中出血少、术后恢复快等诸多优势,是一种安全有效的手术治疗方法。

Objective To compare the clinical efficacy and safety of 1470 nm diode laser and transurethral resection of prostate(TURP) for the treatment of benign prostatic hyperplasia(BPH). Methods From January 2013 to January 2016, 186 cases of BHP were assigned to 1470 nm diode laser group (n=72)and TURP group (n=114). The preoperative clinical parameters of the two groups were comparable not statistically significant.Then operation condition, follow-up and complication rate were compared between two groups.The clinical effect of two group was analyzed. Results The operation time, estimated blood loss(EBL), postoperative catheter remove and hospital stay were significant better in 1470 nm laser group than TURP group(P<0.05). After 3 months follow-up, there were statistically significant differences in Qmax, PVR, IPSS and QOL between pre-operation and post-operation in two groups(P<0.05). There was no significant difference with respect to the complications between two groups(P>0.05). Conclusions Both surgical approaches of 1470 nm diode laser and TURP show good effect for treating BPH, but the 1470 nm diode laser demonstrates better effica-cy with less blood loss, shorter catheter remove time and hospital stay.