汽化切割和电切治疗前列腺增生的效果  

Effect of telectrovaporization and bipolar plasma kinetic resection in the treatment of prostatic hyperplasia

作　　者：孙淑娟[1] 申红梅[1] 王莹[1] 于春虎[1] 信馨[1] 李勤娥 王沛沛[1] 李玉婷[1] 

机构地区：[1]首都医科大学附属北京康复医院泌尿与代谢康复中心,北京100144

出　　处：《中国医药导报》2017年第21期78-81,共4页China Medical Herald

基　　金：首都医学发展科研基金项目(2009-3176)

摘　　要：目的比较汽化切割和双极等离子电切治疗良性前列腺增生的临床效果。方法回顾性分析2013年1月~2016年1月在首都医科大学附属北京康复医院行前列腺手术的120例患者的临床资料,其中60例行经尿道双极等离子电切者为电切组,60例行2μm激光汽化切割治疗者为激光组。对两组患者的手术时间、术中出血情况、术中冲洗液量和术后膀胱冲洗时间、气囊导尿管留置时间、下床活动时间及平均住院时间、症状改善情况等进行统计学处理与分析。结果两组患者手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))、残余尿量(RU)组间比较,差异无统计学意义(P>0.05)。两组患者术后IPSS评分、QOL评分、Q_(max)及RU均优于本组术前(P<0.01);激光组手术时间明显短于电切组(P<0.05),术中冲洗液量及术中出血量明显少于电切组(P<0.01),术后膀胱冲洗时间、气囊导尿管留置时间及平均住院时间均短于电切组,差异均有统计学意义(P<0.01或P<0.05)。结论经尿道2μm激光汽化切割术和等离子电切均是治疗良性前列腺增生的有效手段,但经尿道2μm激光前列腺汽化切割术手术时间短,术中出血量少,冲洗液量少,术后膀胱冲洗时间、留置尿管时间、住院时间短,临床应用优势明显。Objective To compare the clinical efficacy of telectrovaporization and bipolar plasma kinetic resection in the treatment of benign prostatic hyperplasia. Methods The clinical data of 120 patients who underwent prostate surgery in Beijing Rehabilitation Hospital, Capital Medical University from January 2013 to January 2016 were analyzed retrospectively. 60 patients treated with transurethral bipolar plasma kinetic resection were selected as the electric resection group, 60 patients treated with 2 μm laser vaporization cutting were selected as the laser group. The operation time, intraoperative bleeding, amount of irrigation fluid, postoperative bladder irrigation time, foley catheter indwelling time, time to ambulation, and average hospital stay, symptoms improvement situation of two groups were analyzed statistically. Results The international prostate symptom score（IPSS）, life quality score（QOL）, maximum urinary flow rate（Q_（max））, residual urine（RU） volume before and after operation between the two groups had no significant differences（P〈0.05）. The IPSS score, QOL score, Q_（max）and RU after operation in the two groups were all better than those before operation（P〈0.01）. The operation time of laser group was shorter than that of electric resection group（P〈0.05）,intraoperative amount of irrigation fluid and blood loss was less than that of electric resection group（P〈0.01）, the postoperative bladder irrigation time, foley catheter indwelling time and average hospital stay of laser group was shorter than those of electric resection group（P〈0.01 or P〈0.05）. Conclusion Transurethral 2 μm laser and bipolar plasma kinetic resection are both effective methods for the treatment of benign prostatic hyperplasia, but transurethral 2 μm laser has shorter operative time, less intraoperative blood loss, less irrigation saline and shorter postoperative bladder irrigation time, indwelling catheter time, and hospital stay, which has obvious clinical advantages.

关 键 词：2ΜM激光 双极等离子电切 良性前列腺增生 

分 类 号：R697.32[医药卫生—泌尿科学]