保留前列腺尖部对绿激光前列腺汽化术后患者疗效的影响  

Effect of preserving prostate apical tissue on clinical outcomes in men undergoing green light laser vaporization of benign protatic hyperplasia

作　　者：包卿兵[1] 何国华[1] 徐仁美 王伟 王鑫 Bao Qingbing;He Guohua;Xu Renmei;Wang Wei;Wang Xin(Department of Urology,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 225300,China)

机构地区：[1]泰州市中医院泌尿外科,225300

出　　处：《国际泌尿系统杂志》2020年第3期434-437,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨保留前列腺尖部对绿激光前列腺汽化术后患者疗效的影响。方法98例入组患者随机分成A组和B组,A组行绿激光治疗,保留超过精阜的前列腺尖部;B组在A组基础上继续行等离子电切除尖部前列腺组织,比较两组患者手术情况、疗效和并发症。结果B组手术时间、出血量高于A组(P<0.05),留置尿管和住院时间长于A组(P<0.05),而两组在术后8周国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)和残余尿(PVR)差异没有统计学意义(P>0.05)。结论在行经尿道前列腺绿激光汽化术时可以以精阜水平为界,超过精阜水平的远端腺体组织保留,而不影响术后早期排尿改善情况及生活质量。Objective To assess the clinical efficacy of preserving prostate apical tissue on clinical outcomes in men undergoing greenlight laser vaporization of benign prostatic hyperplasia(BPH).Methods From June 2017 to September 2018,98 patients who were diagnosised with BPH were divided into two groups,green lilht laser photoselective vaporization(PVP)only(group A)or PVP in proximal part followed by bipolar transurethral resection(TURP)in distal part of prostatic urethra(group B).Operative outcome,therapeutic efficacy and complications were compared.Results There was no significant differece of preoperative variables such as the mean age,the mean volume of prastate,PSA,IPSS,QOL,Qmax and post void urine retention(PVR)between group A and group B(P>0.05).The operative time was significantly longer in group B(P<0.05).The average amount of bleeding was less in group A(P<0.05).Catheterization time and postoperative hospital stay was significantly shorter in group A(P<0.05).No significant difference was detected in IPSS,QOL,Qmax and PVR between the two groups at 24 hours and 8 weeks after the surgery(P>0.05).Conclusions Preservation of prostate apical tissue does not affect urodynamic parameters or patient's well being,when the prostate lobes of a large BPH extend beyond the verumontanum.

关 键 词：前列腺增生 经尿道前列腺切除术 激光疗法 

分 类 号：R699[医药卫生—泌尿科学]