经尿道绿激光前列腺剜除术与经尿道绿激光前列腺汽化术治疗良性前列腺增生的疗效比较

Comparative study of transurethral green laser enucleation of the prostate and transurethral green laser vaporization of the prostate in the treatment of benign prostatic hyperplasia

目的比较经尿道绿激光前列腺剜除术与经尿道绿激光前列腺汽化术治疗良性前列腺增生的疗效。方法回顾性分析2018年1月至2019年12月于本院收治的161例良性前列腺增生患者的临床资料,其中78例患者行经尿道绿激光前列腺剜除术(剜除组),83例患者行经尿道绿激光前列腺汽化术(汽化组)。比较两组患者的手术时间、术中出血量、术后膀胱冲洗时间、术后留置导尿管时间、术后住院时间、术后并发症发生情况以及术后1、3、6个的国际前列腺症状评分(IPSS)、生活质量(QOL)评分、最大尿流率(Q_(max))。结果剜除组的手术时间较汽化组更长,术中出血量更多,两组比较差异均有统计学意义(均P<0.05);两组患者的术后膀胱冲洗时间、术后留置导尿管时间、术后住院时间比较,差异均无统计学意义(均P>0.05)。剜除组患者术后1、3、6个月的IPSS、QOL评分低于汽化组,差异均有统计学意义(均P<0.05);两组患者术后1、3、6个月Q_(max)比较,差异无统计学意义(P>0.05)。剜除组的尿路感染、膀胱颈痉挛、逆行射精并发症发生率均低于汽化组,暂时性尿失禁发生率高于汽化组,差异均有统计学意义(均P<0.05)。结论经尿道绿激光前列腺剜除术的手术难度大、时间长、出血多,但是并发症更少,术后效果更优,由于其无需在汽化术设备的基础上更换设备,值得临床推广。

Objective To compare the efficacy of transurethral green laser enucleation of the prostate and transurethral green laser vaporization of the prostate in the treatment of benign prostatic hyperplasia.Methods From January 2018 to December 2019,161 patients with benign prostatic hyperplasia admitted to our hospital were retrospectively analyzed.Among them,78 patients underwent transurethral green laser enucleation of the prostate(enucleation group),and 83 patients underwent transurethral green laser vaporization of prostate gland(vaporization group).The operation time,intraoperative blood loss and postoperative bladder of the two groups were compared The duration of irrigation,indwelling catheterization time,postoperative hospital stay,postoperative complications,international prostate symptom score(IPSS),quality of life assessment(QOL),and _(max)imum urine flow rate(Q_(max))were recorded in the two groups at 1,3 and 6 months after operation.Results The operation time of the enucleation group was longer than that of the vaporization group,and the amount of intraoperative blood loss was more.The differences between the two groups were statistically significant(all P<0.05).There were no significant differences in postoperative bladder flushing time,postoperative indwelling catheter time and postoperative hospital stay between two groups(all P>0.05).IPSS and QOL scores of 1,3 and 6 months after operation in the enucleation group were lower than those in the vaporization group,and the differences were statistically significant(all P<0.05).There was no significant difference in Q_(max) between two groups at 1,3 and 6 months after surgery(P>0.05).The incidence of urinary tract infection,bladder neck spasm and retrograde ejaculation complications in the evisceration group was lower than that in the vaporization group,and the incidence of temporary urinary incontinence was higher than that in the vaporization group(all P<0.05).Conclusions Transurethral green laser prostatic enucleation is difficult,time-consuming,and bleeding,but with fewer complications and better postoperative results.Because it does not require equipment replacement on the basis of vaporization equipment,it is worthy of clinical promotion.