摘要
目的比较2μm激光和绿激光在治疗前列腺增生(BPH)中的疗效和安全性。方法回顾性分析2013年5月至2015年12月,苏州大学附属第二医院泌尿外科收治并手术处理的356例BPH患者,其中行国产120 W 2μm激光前列腺汽化切除术196例,行国产160 W绿激光前列腺选择性光汽化术(PVP)160例。比较两组患者术前和术后3个月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(RUV)等变化,以及手术时间、术中血红蛋白和电解质的变化、术后尿管留置时间、术后并发症发生率等指标。结果术前2μm激光和绿激光组患者平均年龄(64/63)岁、前列腺平均体积(59/60)ml、IPSS(21.7±2.8/22.0±2.9)分、QOL(4.2±0.7/4.0±0.8)分、Qmax(6.4±1.8/6.5±1.6)ml/s及PUV(65±20/67±16)ml等比较差异无统计学意义(P>0.05)。两组手术时间分别为(52±7)min和(63±10)min,组间比较差异有统计学意义(P<0.05);手术前后血清[Na+]的减少分别为:(0.92±0.23)mmol/L和(0.93±0.20)mmol/L,手术前后血红蛋白浓度的减少分别为:(5.4±0.7)g/L和(5.2±1.0)g/L,组间比较差异无统计学意义(P>0.05);术后留置尿管时间为:(3.1±0.4)d和(2.9±0.5)d,组间比较差异无统计学意义(P>0.05);术后并发症发生率为:5.10%和5.63%,组间比较差异无统计学意义(P>0.05);术后随访3个月,IPSS、QOL、Qmax及RUV均较术前明显改善(P<0.05),但组间比较差异均无统计学意义(P>0.05)。结论两种激光均能有效汽化切除增生的前列腺组织,并具有出血少、恢复快、安全性高的特点,是微创治疗前列腺增生的良好方法。
Objective To compare the clinical efficacy and safety of 2-μm（thulium） laser resection of the prostate-tangerine technique（Tm LRP-TT） and photoselective vaporization of prostate（PVP） for benign prostatic hyperplasia（BPH）. Methods A total of 356 patients who were diagnosised with BPH in the Second Affiliated Hospital of Soochow University were divided into 2 groups： Tm LRP-TT and PVP. There was no significant difference of preoperative variables such as IPSS, QOL, Qmax and residual urine volume（RUV） between them（P〉0.05）. The perioperative parameters and therapeutic effects were recorded and compared between them. Results In Tm LRP-TT and PVP groups, the relevant parameters were as following： the mean age was 64/63 years, the mean volume of prostate 59/60 ml IPSS（21.7±2.8/22.0±2.9）, QQL（4.2±0.7/4.0±0.8）, Qmax（6.4±1.8/6.5±1.6） ml/s, RUV（65±20/67±16） ml/s the differences weren＇t significant（P〉0.05）. The operative time was（52±7） min and（63±10） min（P〈0.05）. The decrease of serum sodium was（0.92±0.23） mmol/L and（0.93±0.20） mmol/L. The decrease of serum hemoglobin was（5.4±0.7）g/L and（5.2±1.0）g/L,the catheterization time was（3.1±0.4）d and（2.9±0.5）d,the complication rate was 5.10%and 5.63%（P〉0.05）.Three months postoperatively,IPSS,QOL,Qmax and RUV were significantly improved in the two groups（P〈0.05）,but without significant difference between them（P〈0.05）.Conclusions All the two surgical procedures have significant efficacy in the treatment of BPH.The two surgical modalities can be chosen based on different conditions so as to obtain better clinical results.
出处
《中华腔镜泌尿外科杂志（电子版）》
2017年第5期42-45,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
苏州市临床重点病种诊疗技术专项项目(LCZX201506)
关键词
前列腺增生
2ΜM激光
绿激光
前列腺切除术
Benign prostatic hyperplasia
2-μm （thulium） laser
Green Laser
Resection of prostate
