经尿道1470 nm激光前列腺汽化切除术与前列腺电切术治疗前列腺增生的临床疗效比较

A comparative study on the clinical effects of 1470 nm diode laser vaporization and TURP for benign prostatic hyperplasia

目的良性前列腺增生(BPH)是中老年男性最常见的泌尿外科疾病,又称结节性增生。通过比较经尿道1470 nm半导体激光汽化切除术治疗BPH与前列腺电切术(等离子)治疗BPH的临床疗效,验证经尿道1470 nm半导体激光汽化切除术的安全性及先进性,为临床推广经尿道1470 nm半导体激光汽化术治疗BPH提供理论依据。方法选取本院2017年3月至2018年3月收治的BPH患者60例作为研究对象,按照治疗方法不同分为1470激光组与等离子电切组,各30例。其中1470激光组经尿道1470 nm半导体激光汽化切除术治疗,等离子电切组通过等离子电切治疗。比较两组患者的手术时间、术后住院时间、留置尿管时间、膀胱冲洗时间及术后尿路感染和尿失禁的发生率;同时对比患者手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)及最大尿流率(Qmax)。分析两组患者的手术前后各项重要数据并总结出两种手术方法的优缺点。结果两组手术时间、膀胱冲洗时间、留置尿管时间、术后住院时间差异无统计学意义。分别比较分析等离子电切组与激光组术前术后各指标变化值,两组患者术后基本情况比较差异无统计学意义。两组手术并发症比较差异无统计学意义。结论1470 nm激光和等离子电切术两种术式均有效,但是尿道1470 nm半导体激光汽化切除术的安全性及先进性并未优于前列腺电切术。

Objective To compare the clinical efficacy of transurethral 1470 nm semiconductor laser vaporization resection for BPH and prostate resection(plasma)in the treatment of BPH,to verify the safety and advancement of transurethral 1470 nm semiconductor laser vaporization resection,to promote the transurethral 1470 nm semiconductor laser Vaporization provides a theoretical basis for the treatment of BPH.Methods 60 patients with BPH admitted to our hospital from March 2017 to March 2018 were collected and sorted out.According to different treatment methods,they were divided into 1470 laser group and plasma electrotomy group,with 30 cases in each group.Among them,1470 laser group was treated by transurethral 1470 nm semiconductor laser vaporization resection,while plasma electrotomy group was treated by plasma electrotomy.The operation time,postoperative hospital stay,indwelling catheter time,bladder irrigation time,and the probability of postoperative urinary tract infection and urinary incontinence were compared between the two groups.The international prostate symptom score(IPSS)and quality of life score were compared before and after surgery.(QOL),residual urine volume(PVR)and maximum urine flow rate(Qmax).The important data of the two groups before and after surgery were analyzed and the advantages and disadvantages of the two surgical methods were summarized.Results There was no significant difference between the two groups in operation time,bladder irrigation time,indwelling catheter time,and postoperative hospital stay.The changes of the indexes of the plasma resection group and the laser group before and after the operation were compared and compared.The results showed no statistical difference,indicating that the postoperative basic conditions were similar in the two groups,no significant difference.The t-test method was used to compare the surgical complications between the two groups.The results showed no statistical difference,indicating that there was no significant difference between the two groups.Conclusion Both 1470 nm laser and plasma electrotomy are effective,but the safety and advancement of urethral 1470 nm semiconductor laser vaporization resection is not superior to prostate resection.