经尿道选择性绿激光前列腺汽化术治疗良性前列腺增生的临床效果评价

Evaluation of clinical efficacy of photoselective vaporization of the prostate for treatment of be-nign prostatic hyperplasia

目的探讨经尿道选择性绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)的临床效果。方法回顾性分析2018年7月至2019年12月收治的167例BPH患者的临床资料,根据手术方式分为观察组(78例)和对照组(89例),观察组行PVP术,对照组行经尿道前列腺切除术(TURP),比较两组患者的手术时间、膀胱冲洗时间、留置导尿时间、血红蛋白降低指数、出血量、术后住院时间及术后并发症,并对两组患者术后1、6及12个月的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、生活质量评分(QOL)及残余尿量(PVR)进行比较。结果观察组的膀胱冲洗时间、留置导尿时间、血红蛋白降低指数、术中出血量及术后住院时间明显低于对照组(t=-15.755、-7.458、-24.667、-30.332、-10.328,P<0.05)。而观察组的手术时间及住院费用明显高于对照组(t=13.699、5.179,P<0.05);两组患者的术后1、6、12个月IPSS、Qmax、QOL及PVR比较,差异无统计学意义(P>0.05);观察组电切综合征、继发性出血及短暂排尿困难发生率低于对照组(χ2=4.517、4.842、4.722,P<0.05)。结论 PVP治疗BPH的临床效果与TURP相当,是一种治疗BPH安全有效的新方法,具有创伤小、恢复快、出血少、住院时间短及并发症少等优势,尤其适合于高危、高龄患者。

Objective To explore the clinical effcacy of photoseleetive vaporization of the prostate(PVP)for treatment of benign prostatic hyperplasia(BPH).Methods The clinical data of 167 cases with BPH were analyzed retrospectively,and divided into the observation group(PVP,n=78)and control group(TURP,n=89)according to the 0 surgical procedures.The operation time,blad-der irrigation time,intubation time,drop in hemoglobin,blood loss,postoperative hospitalization time,complications,and the postoperative 1,6 and 12 months change value of international prostate symptom score(IPSS),maximum urinary flow rate(Qnx),postvoid residua(PVR)and quality of life(Q0L)score of the two groups were compared.Results The bladder irrigation time,intubation time,drop in hemoglobin,blood loss and postoperative hospitalization time were sigificant lower in observation group than in control group(t=-15.755,-7.458,-24.667,-30.332,-10.328,P<0.05).The opera-tion time and hospitalization expenses in observation group was significantly higher than in control group(t=13.699,5.179,P<0.05);There were no significant difference in IPSS,Qm,QOL and PVR between the two groups at postoperative1,6,12 months(P>0.05).The rate of transurethral resection syndrome,secondary bleeding and temporality dysuresia for observation group were lower than that for control group(X^2=4.517,4.842,4.722,P<0.05).Conclusions PVP is as effective as TURP for the treatment of BPH,and as an novel excellent treatment for the treatment of BPH,it has the advantage.of small trauma,faster recovery,less bleeding,shorter hospitalization time and less complicatons,and it is especially appropriate to the patients of high danger and advanced age.