天津医药

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经尿道前列腺增生绿激光汽化术与汽化电切术的疗效比较

李健1,冯起庆2,张廷继2,侯瑞鹏2,张志华2,李昭夷2   

  1. 1. 天津市人民医院泌尿外科
    2. 天津市人民医院
  • 收稿日期:2010-05-31 修回日期:2010-08-13 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 李健

Greenlight photoselective vaporization of prostate versus transurethral electrovaporization resection of prostate for benign prostatic hyperplasia

  • Received:2010-05-31 Revised:2010-08-13 Published:2011-03-15 Online:2011-03-15

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摘要： 目的: 评价经尿道前列腺选择性绿激光汽化术(PVP)与经尿道前列腺汽化电切术(TUVP)的疗效及安全性。方法: 将BPH患者220例随机分为两组，分别行经尿道前列腺选择性绿激光汽化术(PVP组)和经尿道前列腺汽化电切术(TUVP组)，比较两种术式的手术时间、术中出血量、近期疗效及并发症等情况。结果: 两组术后国际前列腺症状评分( IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、剩余尿量均比术前明显改善(P＜0.05)，但两组上述指标之间比较差异无统计学意义(P＞0.05)。TUVP组手术时间平均(41±15)min，PVP组则为平均(48±27)min，TUVP手术操作时间短于PVP组，但差异无统计意义(P＞0.05)。PVP组术中出血量少、拔除尿管早，优于TUVP(P＜0.05)。随访术后6月两组前列腺症状评分及最大尿流率疗效相近。TUVP组术后血尿明显(30.0%)。结论: P与TUVP相比，VP治疗BPH近期疗效相似，具有手术过程安全、恢复快、并发症少等特点，是一种治疗BPH安全有效的理想微创术式。

关键词: 前列腺增生, 经尿道前列腺切除术, 生活质量, 外科手术, 微创性

Abstract: Abstract Objective: To compare the therapeutic effects of the greenlight photoselective vaporization of prostate(PVP) and transurethral electrovaporization resection of prostate (TUVP) for the treatments of symtomatic benign prostatic hyperplasia (BPH). Methods: 220 cases of BPH were treated with PVP or TUVP.Various parameters such as operation time，blood loss and complications were recorded and analyzed. Results: The international prostatic symptom score (IPSS)，quality of life (QOL)，Qmax and postvoid residual urine volume (RUV) were significantly improved after both of the procedures and therapeutic results(P＜0.05). No significant difference in the improvement of subjective sympotoms and objective results has been noted with the different procedures (P＞0.05).Mean operative time was (41±15)min for TUVP and (48±27)min for PVP group. The resection time was longer for PVP group than TUVP (P＞0.05)，but the interoperative bleeding and catheterization time were less in PVP group than TUVP (P＜0.05). Postoperative complications were less in PVP group than TUVP (P＜0.05).The incideased of heamatouria in TUVP group had been 30% and the patients need bladder irrigation. Conclusions: The PVP has similar therapeutic effect as TUVP for the treatment of symptomatic BPH. PVP is regarded as shorter operative and recovering time，less blood loss and complication for the patients with BPH.PVP is a safe and effective ideal minimally invasive surgery treatment for the BPH.

Key words: prostatic hyperplasia, transurethral resection of prostate laser therapy, quality of life, surgical procedures, minimally invasive