TPLA与TURP治疗BPH的疗效对比:一项单中心前瞻性随机对照研究  

Comparison of the effects of transperineal prostate laser ablation versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia:a single center prospective randomized controlled study

作　　者：姚振 吉运华 王林猛 薛琦 石曼曼 罗志嵘 张波 YAO Zhen;JI Yunhua;WANG Linmeng;XUE Qi;SHI Manman;LUO Zhirong;ZHANG Bo(Department of Urology,Tangdu Hospital,The Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学附属唐都医院泌尿外科,陕西西安710032

出　　处：《现代泌尿外科杂志》2024年第6期486-491,共6页Journal of Modern Urology

基　　金：国家自然科学基金项目(No.81872077,No.31272391)。

摘　　要：目的比较经会阴前列腺激光消融术(TPLA)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的临床疗效。方法选择2021年10月—2022年10月空军军医大学附属唐都医院收治的60例BPH患者作为研究对象,随机分为TPLA组(n=30)和TURP组(n=30)。比较两组患者的术中出血量、手术时间、留置导尿管时间、住院时间、术后性功能障碍及手术相关并发症的情况。比较两组患者术前及术后1、3、12个月的国际前列腺症状评分(IPSS)、勃起功能专项评分(IIEF-5)、最大尿流率(Qmax)、生活质量评分(QoL)、残余尿量(PVR)、前列腺体积(PV)。结果TPLA组患者的术中出血量、手术时间和住院时间明显少于TURP组,但留置导尿管时间长于TURP组(P<0.05)。两组患者术后1、3、12个月IPSS和Qmax较术前有显著改善(P<0.05);TPLA组术后1、3个月的IPSS高于TURP组(P<0.05);TPLA组患者术后1、3、12个月的Qmax低于TURP组(P<0.05);两组术后IIEF-5比较,TPLA组优于TURP组(P<0.05)。两组术后的QoL、PV、PVR水平均优于术前(P<0.05);TPLA组术后1、12个月的QoL低于TURP组(P<0.05);TPLA组术后1、3、12个月的PV和PVR均高于TURP组(P<0.05)。TPLA组手术相关并发症发生率(3.33%vs.26.67%)及术后性功能障碍发生率(3.33%vs.36.67%)均低于TURP组(P<0.05)。结论相较于TURP,TPLA治疗BPH疗效显著、对性功能影响较小,为BPH患者治疗方式的选择提供了一种全新的思路,可作为临床治疗BPH的有效补充手段。Objective To compare the clinical efficacy of transperineal prostate laser ablation(TPLA)and transurethral resection of the prostate(TURP)in the treatment of benign prostatic hyperplasia(BPH).Methods A total of 60 BPH patients diagnosed during Oct.2021 and Oct.2022 at Tangdu Hospital were selected as the research subjects and randomly divided into the TPLA group(n=30)and TURP group(n=30).The intraoperative bleeding volume,operation time,catheter indwelling time,length of hospital stay,postoperative sexual dysfunction,and surgical related complications were compared between the two groups.The international prostate symptom score(IPSS),international index of erectile function-5(IIEF-5),maximum urinary flow rate(Qmax),quality of life score(QoL),postvoid residual(PVR)and prostate volume(PV)were compared between the two groups before surgery and 1,3,and 12 months after surgery.Results The TPLA group had significantly less intraoperative bleeding volume,shorter operation time and length of hospital stay compared to the TURP group,but longer catheter indwelling time(P<0.05).Both groups showed significant improvement in IPSS and Qmax 1,3,and 12 months postoperatively compared to preoperative(P<0.05),the IPSS of the TPLA group was significantly higher than that of the TURP group 1 and 3 months after surgery(P<0.05);the Qmax of TPLA group 1,3,and 12 months after surgery was lower than that of the TURP group(P<0.05).The IIEF-5 score was significantly better in the TPLA group than in the TURP group after surgery(P<0.05).The postoperative QoL,PV,and PVR levels in both groups improved after surgery(P<0.05),the QoL of the TPLA group was lower than that of the TURP group 1 and 12 months after surgery(P<0.05),the PV and PVR of the TPLA group were higher than those of the TURP group 1,3,and 12 months after surgery(P<0.05).The incidence of surgery-related complications(3.33%vs.26.67%)and postoperative sexual dysfunction(3.33%vs.36.67%)in the TPLA group were lower than those in the TURP group(P<0.05).Conclusion TPLA shows significan

关 键 词：良性前列腺增生 经会阴前列腺激光消融术 经尿道前列腺电切术 性功能 

分 类 号：R699[医药卫生—泌尿科学]