1470nm半导体激光汽化剜除术治疗前列腺增生的疗效

Comparison of clinical effect between 1 470 nm laser resection of prostate and transurethral resection of prostate

目的比较1 470 nm半导体激光汽化剜除术(LRP)与经尿道前列腺电切术(TURP)的临床疗效。方法回顾性分析2014年5月至2016年3月连云港市第二人民医院收治的良性前列腺增生症(BPH)而导致膀胱出口梗阻的患者100例,数字法随机分成2组:激光组(50例)和TURP组(50例)。分析比较两组围手术期相关指标。结果术后随访3个月。TURP组术前国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)分别为(21.7±6.2)分、(4.2±1.1)分、(9.0±2.3)ml/s、(111.8±32.7)ml,术后各项指标分别为(11.3±3.4)分、(1.5±0.7)分、(16.4±3.0)ml/s、(22.9±8.3)ml;LRP组术前IPSS、QOL、Qmax、PVR分别为(23.1±5.8)分、(4.4±1.0)分、(9.4±3.0)ml/s、(113.7±29.8)ml,术后各项指标分别为(12.2±3.2)分、(1.3±0.8)分、(16.9±3.2)ml/s、(23.7±9.8)ml,两组术后IPSS、QOL、Qmax、PVR均比术前改善(P<0.05)。但组间比较差异无统计学意义(P>0.05)。LRP组在术后膀胱冲洗时间、置管时间和术后住院时间,均较LRP组短(P<0.05)。此外,LRP组手术时间较长(P<0.05),所切除前列腺重量少于TURP组(P<0.05)。结论两种切除方式在近期疗效无明显差异,但LRP术中出血量少,尿管留置时间短,安全性较高。

Objective To compare the clinical therapeutic effect of transurethral resection of prostate between 1 470 nm laser resection of prostate(LRP) and transurethral resection of prostate(TURP). Methods 100 BPH patients suffering from bladder outlet obstruction were randomly divided into two groups of A(LRP, 50 cases) and B(TURP, 50 cases). The clinical data in preoperative period from two groups were especially compared and analyzed. Results All patients were followed up for 3 months. In the TURP group, the international prostate symptom score(IPSS), quality of life score(QOL), maximum urinary flow rate(Qmax) and residual urine volume(PVR) were 21.7±6.2, 4.2±1.1,(9.0±2.3)ml/s,(111.8±32.7)ml before operation, and were 11.3±3.4, 1.5±0.7,(16.4±3.0)ml/s,(22.9±8.3)ml post-operation respectively. In the LRP group the IPSS, QOL, Qmax, PVR were 23.1±5.8, 4.4±1.0,(9.4±3.0)ml/s,(113.7±29.8)ml before operation, and were 12.2±3.2, 1.3±0.8,(16.9±3.2)ml/s,(23.7±9.8)ml post-operation respectively. The postoperative markers were improved compared with that of pre-operatively in every group(P<0.05), but there were no remarkable difference between two groups(P>0.05). In addition, the group of LRP had a longer operative time(P<0.05), and the resected tissues were less than TURP group(P<0.05). Conclusions Though there is no obvious difference between the two types of resection in the short-term effect, LRP is more dominant: the amount of bleeding during operation is lower, the indwelling time of catheter is shorter, and the safety is higher.