绿激光前列腺汽化切除术与低压灌注下四区分割前列腺等离子剜除术治疗高龄高危良性前列腺增生患者的临床效果比较  

Comparison of the green laser photoselective vaporesection of prostate and four area division plasmakinetic enucleation of prostate in treating elderly patients with high-risk benign prostatic hyperplasia

作　　者：李小鑫 朱建 鞠建 陈海燕 解吕中 LI Xiaoxin;ZHU Jian;JU Jian;CHEN Haiyan;XIE Lyuzhong(Department of Urology,Nantong Hospital of Traditional Chinese Medicine,Affiliated Traditional Chinese Medicine Hospital of Nantong University,Nantong 226001,Jiangsu,China)

机构地区：[1]江苏省南通市中医院泌尿外科,江苏南通226001

出　　处：《中国性科学》2021年第2期14-17,共4页Chinese Journal of Human Sexuality

基　　金：江苏省南通市科技局科研项目(MSZ18213);南通市卫健委科研项目(WKZL2018042)。

摘　　要：目的观察比较绿激光前列腺汽化切除术(PVRP)与低压灌注下四区分割前列腺等离子剜除术(FPKEP)治疗高龄高危良性前列腺增生(BPH)的临床疗效。方法选取2017年8月至2019年9月江苏省南通市中医院治疗的68例高龄高危BPH患者作为研究对象。根据治疗方式不同分为PVRP组(n=36)和FPKEP组(n=32)。比较两组手术时间、手术出血量、血钠改变、术后导尿管留置时间、膀胱冲洗时间和手术后并发症的情况,以及手术前后国际前列腺症状(IPSS)评分、生活质量(QOL)评分、残余尿量(PVR)和最大尿流率(Qmax)相关指标。结果PVRP组手术时间、术中出血量明显少于FPKEP组,差异具有统计学意义(P<0.05);两组血钠变化、导尿管留置时间、膀胱冲洗时间比较,差异无统计学意义(P>0.05);两组术后IPSS评分、QOL评分、Qmax均较术前明显改善,差异具有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05);两组均无输血和二次手术病例,且尿失禁等并发症发生率低。结论PVRP和FPKEP治疗高龄高危BPH均安全可靠、疗效确切,而PVRP术中出血量少,手术时间更短。Objective To compare the efficacy of green laser photoselective vaporesection of prostate(PVRP)and four area division plasmakinetic enucleation of prostate(FPKEP)under lwo-pressure perfusion for elderly patients with high-risk benign prostatic hyperplasia(BPH).Methods 68 elderly patients with high-risk BPH treated in Nantong Hospital of Traditional Chinese Medicine,Affiliated Traditional Chinese Medicine Hospital of Nantong University from August 2017 to September 2019 were selected as the research subjects.According to different treatment methods,they were divided into PVRP group(n=36)and FPKEP group(n=32).The operative time,operative bleeding volume,changes in blood sodium,indwalling catheter time,bladder irrigation time and complications after operation were compared between the two groups,as well as the international prostate symptom score(IPSS),quality of life(QOL)score,postvoid residual urine(PVR)and maximum urinary flow rate(Qmax)before and after surgery.Results The operative time and bleeding volume in PVRP group were significantly shorter than those in FPKEP group(P<0.05).There were no significant differences in serum sodium change,catheter indwelling time and bladder irrigation time between the two groups(P>0.05).Postoperative IPSS score,QOL score and Qmax of the two groups were significantly improved compared with those before surger(P<0.05),but there was no statistical significance between the two groups(P>0.05).There were no cases of blood transfusion or secondary surgery in the two groups,and the incidence of complications such as urinary incontinence was low.Conclusions PVRP and FPKEP are safe and efficient procedures for the treatment of elderly and high-risk BPH.PVRP has the advantages of shorter operation time and less bleeding.

关 键 词：绿激光前列腺汽化切除术 前列腺等离子剜除术 良性前列腺增生 

分 类 号：R697[医药卫生—泌尿科学]