半导体激光汽化术与经尿道前列腺双极等离子电切术治疗良性前列腺增生的效果比较

Effects of semiconductor laser vaporization and transurethral plasma kinetic resecti of prostate on benign prostatic hyperplasia

目的对比1 470 nm半导体激光汽化术与经尿道前列腺双极等离子电切术(TKRP)治疗良性前列腺增生(BPH)的临床效果。方法选取2017年9月至2018年12月广西壮族自治区民族医院收治的100例BPH患者,根据随机数字表法分为激光组和TKRP组,各50例。激光组采用1 470 nm半导体激光前列腺汽化术,TKRP组采用TKRP。比较2组一般指标,术前及术后3个月国际前列腺症状评分(IPSS评分)、生活质量评分(QOL评分)、最大尿流率,术后并发症发生情况及性功能情况。结果激光组手术时间长于TKRP组,血红蛋白下降量、留置尿管时间、住院时间小于/短于TKRP组,差异均有统计学意义(均P <0.05)。术后3个月激光组IPSS评分、QOL评分低于TKRP组,最大尿流率高于TKRP组[(3.5±1.4)分比(9.6±2.3)分、(1.1±0.4)分比(2.8±1.2)分、(25.5±3.5) ml/s比(19.5±1.3) ml/s],差异均有统计学意义(均P <0.05)。激光组术后并发症发生率和勃起障碍、逆行射精发生率均低于TKRP组,差异均有统计学意义(均P <0.05)。结论与TKRP相比,1 470 nm半导体激光治疗BPH出血量更少、住院时间更短、术后并发症发生率更低,更利于患者的恢复,且安全性更高,对患者性功能影响更小。

Objective To compare the effects of 1 470 nm semiconductor laser vaporization and transurethral plasma kinetic resecti of prostate( TKRP) on benign prostatic hyperplasia( BPH). Methods From September2017 to December 2018,100 patients with BPH were randomly divided into laser group( 50 cases) and TKRP group( 50 cases). The laser group was treated with 1 470 nm semiconductor laser vaporization of prostate,and the TKRP group had TKRP. The international prostate symptom score( IPSS score),quality of life score( QOL score),maximum urine flow rate,postoperative complications and sexual function were compared between the two groups before and 3 months after operation. Results The operation time in laser group was slightly longer,the decrease of hemoglobin,the time of indwelling catheter and the length of hospitalization in laser group were less/shorter than those in TKRP group( all P < 0. 05). The IPSS and QOL scores of the laser group were lower than those of the TKRP group;the maximum urine flow rate was higher than that of the TKRP group at 3 months postoperatively[( 3. 5 ± 1. 4) vs( 9. 6 ± 2. 3),( 1. 1 ± 0. 4) vs( 2. 8 ± 1. 2),( 25. 5 ± 3. 5) ml/s vs( 19. 5 ±1. 3) ml/s,all P < 0. 05]. The incidence of postoperative complications,erectile dysfunction and retrograde ejaculation in the laser group were lower than those in the TKRP group( all P < 0. 05). Conclusion In the treatment of prostatic hyperplasia,compared with TKRP,1 470 nm semiconductor laser has less blood loss,shorter hospital stay,lower incidence of postoperative complications,better recovery of patients,higher safety and less impact on sexual function of patients.