经尿道前列腺绿激光汽切术对老年高危前列腺增生患者近期疗效及性功能的影响

The effects of transurethral green laser photoselective vaporization of prostate on short-term efficacy and sexual function of elderly patients with high-risk benign prostatic hyperplasia

目的观察经尿道前列腺绿激光汽切术(PVP)对老年高危前列腺增生(BPH)治疗效果及对患者性功能影响。方法选取110例老年高危BPH患者,采用随机数字表法分为观察组和对照组各55例,观察组采取PVP手术,对照组采取传统经尿道前列腺电切术(TURP),记录两组围术期指标及术后并发症发生率,分别于术前及术后1、3月评价国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿量(PVR),术前、术后6个月采用国际勃起功能指数(IIEF-5)、BPH患者生活质量简表(BPHQLS)评价患者性功能及生活质量。结果观察组手术时间、手术前后血红蛋白降低幅度、术后膀胱冲洗时间、导尿管留置时间、住院时间及术后并发症总发生率均低于对照组(P<0.05);术后1、3月,两组IPSS评分及RUV均低于术前、Qmax高于术前(P<0.05),但两组间比较差异无统计学意义(P>0.05);术后6月,观察组IIEF-5、BPHQLS评分均高于对照组(P<0.05)。结论PVP与TURP均是老年高危BPH患者有效手术方式,且PVP具有手术时间短、出血量小、并发症少、术后恢复快、对性功能影响小等优势,更利于提高患者生活质量。

Objective To observe the effects of transurethral green laser photoselective vaporization of prostate(PVP)on elderly patients with high-risk benign prostatic hyperplasia(BPH)and its effects on sexual function.Methods A total of 110 elderly patients with high-risk BPH were selected and divided into observation or control group according to the random number table method,55 in each group.The observation group was treated with PVP while the control group was treated with traditional transurethral resection of the prostate(TURP).The perioperative indicators and incidence rates of postoperative complications were recorded,and the International Prostate Symptom Score(IPSS),maximum urinary flow rate(Qmax)and post-voiding residual volume(PVR)were evaluated before and after 1 month and 3 months of surgery.The International Index of Erectile Function(IIEF-5)and BPH patient Quality of Life Scale(BPHQLS)were used to evaluate the sexual function and quality of life of patients before and after 6 months of surgery.Results The operative time,reduction of hemoglobin before and after surgery,postoperative bladder irrigation time,urine catheter indwelling time and hospital stay in the observation group were significantly shorter or lower than those in the control group(P<0.05).The total incidence rate of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).After 1 month and 3 months of surgery,IPSS score and RUV in the two groups were significantly lower while Qmax was significantly higher than that before surgery(P<0.05).However,there were no significant differences in IPSS score,Qmax and RUV between the two groups at the same time point(P>0.05).After 6 months of surgery,the scores of IIEF-5 and BPHQLS in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Both PVP and TURP are effective surgical methods for elderly patients with high-risk BPH.PVP has the advantages of shorter operative time,less bleeding,fewer complications,faster postoperative recovery and less impact on sexual function.It is more conducive to improve the quality of life of the patients.