高功率绿激光汽化术与双极等离子电切治疗高危高龄BPH疗效比较  

Transurethral bipolar plasmakinetic resection of prostate versus high-power green laser photoselective vaporization for the treatment of eldly benign prostatic hyperplasia men with high surgical risk

作　　者：王健[1] 艾星[2] 贾卓敏[2] 滕竞飞[2] 

机构地区：[1]安徽医科大学研究生学院,合肥230032 [2]北京军区总医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2015年第3期141-144,151,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的对比经尿道前列腺双极等离子电切术(transurethral bipolar plasmakinetic resection of the prostate,TUPKRP)与高功率选择性前列腺绿激光汽化术(green laser photoselective vaporization,PVP)治疗高危高龄良性前列腺增生(benign prostatic hyperplasia,BPH)患者的临床疗效和安全性。方法 68例高危高龄的BPH患者为研究对象,其中33例行TUPKRP治疗,35例行PVP治疗。比较两组术前和术后6个月的国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(quality of life,QOL)、最大尿流率(maximum flow rate,Qmax)、残余尿(residual urine,RUV)以及手术时间、术中出血量、术后留置尿管时间、术后住院时间及远期并发症等情况。结果两组患者术后的IPSS评分、QOL评分、Qmax、RUV均较术前取得了明显的改善,在TUPKRP组,术后6个月的IPSS评分由(22.0±5.5)分降至(4.0±2.1)分,Qmax由术前的(7.5±2.7)ml/s升至(18.5±2.7)ml/s,RUV由术前的(100.1±32.4)ml降至(26.3±22.4)ml;在PVP组,IPSS评分由(21.0±7.5)分降至(4.0±2.5)分,Qmax由术前的(7.4±2.8)ml/s升至(18.4±3.2)ml/s,RUV由术前的(100.8±31.2)ml降至(25.8±23.2)ml,两组间差异无统计学意义(P>0.05)。但PVP组的术中出血量、术后留置尿管时间及术后住院时间均优于TUPKRP组(P<0.05),术后并发症无明显差异。PVP组手术时间较TUPKRP组长(P<0.05)。结论两种手术方式对于高危高龄BPH患者在良好控制内科疾病的情况下均有明确的临床疗效,但PVP术中出血少、术后住院时间更短,较TUPKRP更具优势、更安全。Objective To compare the clinical effects and safety between transurethral bipolar plasmakinetic resection of the prostate （TUPKRP） and high-power green laser photoselective vapori- zation （PVP） in eldly benign prostatic hyperplasia （BPH） men with high surgical risk. Methods 68 cases of BPH with at least one internal disease were divided into two groups： 33 cases in TUPKRP group and 35 cases in PVP group. The clinical data of all the patients were collected and compared between the TUPKRP group and PVP group, including pre-operation and six month after opera- tion international prostate symptom score （IPSS）, quality of life （QOL）, urine flow rate （Qmax）, residual u- rine （RUV） as well as operational time, operative bleeding volume, time of indwelling catheter after opera- tion, hospitalization time after operation and complications after operation. Results Two groups had significantly improved both in IPSS, QOL, Qmax and and also in RUV after the operation. The IPSS greatly changed from （22. 0±5. 5） down to （4. 0±2. 1）% Qmax from （7.5±2. 7）ml/s up to （18.5±2.7）ml/s; RUV from （100.14±32.4）ml down to （26.3±22.4）ml in TUPKRP six months after surgery. Meanwhile, the IPSS greatly changed from （21.0±7.5） down to （4.0±2.5） ; Qmax from （7.4±2.8）ml/s up to （18.4±3.2）ml/s RUV from （100.8±31.2）ml down to （25.8±23.2）ml in PVP six months af- ter operation. The difference between the two groups had no significance in statistics （P〈0.05）. However, there were signifi- cant difference between the two groups in the operative bleeding volume, time of indwelling catheter after operation and hospi- talization time after operation. PVP is superior to TUPKRP. Complications after operation showed no difference. The opera- tion time of the PVP was longer than that of the TUPKRP. Conclusions For surgical treatment of eldly men with high surgical risk, both TUPKRP and PVP are safe and effective to patients with sufficiently controlled internal d

关 键 词：前列腺增生 经尿道前列腺双极等离子电切术 经尿道绿激光汽化切除术 

分 类 号：R699.8[医药卫生—泌尿科学]