目的对比分析经尿道前列腺绿激光剜除术(green laser enucleation of prostate,GreenLEP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生症(benign prostatic hyperplasia,BPH)的效果。方法回...目的对比分析经尿道前列腺绿激光剜除术(green laser enucleation of prostate,GreenLEP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生症(benign prostatic hyperplasia,BPH)的效果。方法回顾性分析本院2017年2月至2018年11月收治的BPH患者104例,分别接受绿激光剜除术(GreenLEP组,52例)和电切术(TURP组,52例)治疗,评测两组患者手术时间、术中出血量、手术切除的前列腺体积以及术后膀胱冲洗时间、术后尿管留置时间、住院时间等相关指标,并比较手术前及手术后1、6个月的前列腺症状评分(IPSS)、生活质量(QoL)、最大尿流率(Qmax)、剩余尿量(PVR)、前列腺特异性抗原(PSA)、前列腺体积(PV)等指标。结果两组患者术后的Qmax、QoL、PVR、PSA、PV、IPSS和IIEF指标均较术前明显改善(P<0.001)。GreenLEP组的Qmax[(22.03±3.01)vs(19.08±2.62) mL/s,P<0.001]和IPSS评分[(5.35±1.67)vs(7.92±2.19),P<0.001]优于TURP组,但两组QoL、PVR、PSA、PV等差异无统计学意义。手术安全性比较:GreenLEP组在PV≤60 mL(较小体积)时术后膀胱冲洗时间优于TURP组[(18.88±2.36)vs(34.33±2.90)h,P<0.001];GreenLEP组在前列腺中等体积(60 mL<PV<80 mL)时术中出血量[(63.30±4.27)vs(77.28±6.19)mL,P<0.001]、术后膀胱冲洗时间[(23.11±1.91)vs(41.56±3.15)h,P<0.001]、术后住院时间[(3.07±0.61)vs(3.88±0.88)d,P<0.001]均优于TUPR组,而两组手术时间及前列腺切除体积差异无统计学意义;GreenLEP组在PV≥80 mL(较大体积)时,在所有监测指标上均优于TURP组(P<0.001)。GreenLEP组术后一过性尿失禁发生率高于TURP组,而GreenLEP术后低钠血症、性功能障碍、电切综合征发生率及术后输血率显著低于TURP组,差异均有统计学意义(P<0.05)。结论 GreenLEP治疗BPH患者与TURP效果相当,在减少术中出血、术后膀胱冲洗时间、术后住院时间及降低术后并发症发生率上有明显优势,可能更加适合前列腺体积较大展开更多
Objective: To observe the clinical effectiveness of Qinghuang Powder (青黄散, QHP) combined with Bupi Yishen Decoction (补脾益肾汤 BPYS) in treating myelodysplastic syndrome (MDS), and its relationship with Fra...Objective: To observe the clinical effectiveness of Qinghuang Powder (青黄散, QHP) combined with Bupi Yishen Decoction (补脾益肾汤 BPYS) in treating myelodysplastic syndrome (MDS), and its relationship with France, America, and Britain (FAB) type, international prognosis scaling system (IPSS) risk, and chromosome karyotype. Methods: There were 124 MDS patients subjected to the tests. By FAB typing, 91 patients were typed as refractory anemia (RA) type and 33 as refractory anemia with excess of blasts (RAEB) type; by IPSS scale, 21 were sorted to low risk, 77 to moderate risk I, 20 to moderate risk ]], and 6 to high risk; 78 of them had normal chromosome and 46 with abnormal chromosome, including 26 of trisomy 8. All patients were treated with QHP+BPYS, and the changes of peripheral blood figure and bone marrow were observed. Results: After treatment, the general effective rate was 72.58% (90/124), which in the patients of RA type was 80.22% (73/91) and in RAEB type 51.52% (17/33). The former was better than that in the later (P〈0.01). For the analysis in the patients of different IPSS risk degrees, the effective rate was 95.24% (20/21) in the low- risk group, 72.73% (56/77) in moderate risk I, 65.00% (13/20) in moderate-risk 11, and 16.67% (1/6) in high- risk group. Those in the first two groups were superior to that in the latter two (P〈0.01). The effective rate was 79.49% (61/78) in the patients with normal chromosome and was 60.87% (28/46) in the patients with abnormal chromosome, showing a significant difference between them. While in the patients of trisomy 8, it was 73.08% (19/26), which was parallel to that in the patients with normal chromosome. Conclusion: The effectiveness of QHP+BPYS comprehensive therapy for MDS is unquestionably good, and it is markedly correlated with the FAB type and IPSS risk degree of the disease, as well as the normality of chromosome in the patient.展开更多
基金Supported by the National Natural Science Foundation of China (No.30973903,30973812)
文摘Objective: To observe the clinical effectiveness of Qinghuang Powder (青黄散, QHP) combined with Bupi Yishen Decoction (补脾益肾汤 BPYS) in treating myelodysplastic syndrome (MDS), and its relationship with France, America, and Britain (FAB) type, international prognosis scaling system (IPSS) risk, and chromosome karyotype. Methods: There were 124 MDS patients subjected to the tests. By FAB typing, 91 patients were typed as refractory anemia (RA) type and 33 as refractory anemia with excess of blasts (RAEB) type; by IPSS scale, 21 were sorted to low risk, 77 to moderate risk I, 20 to moderate risk ]], and 6 to high risk; 78 of them had normal chromosome and 46 with abnormal chromosome, including 26 of trisomy 8. All patients were treated with QHP+BPYS, and the changes of peripheral blood figure and bone marrow were observed. Results: After treatment, the general effective rate was 72.58% (90/124), which in the patients of RA type was 80.22% (73/91) and in RAEB type 51.52% (17/33). The former was better than that in the later (P〈0.01). For the analysis in the patients of different IPSS risk degrees, the effective rate was 95.24% (20/21) in the low- risk group, 72.73% (56/77) in moderate risk I, 65.00% (13/20) in moderate-risk 11, and 16.67% (1/6) in high- risk group. Those in the first two groups were superior to that in the latter two (P〈0.01). The effective rate was 79.49% (61/78) in the patients with normal chromosome and was 60.87% (28/46) in the patients with abnormal chromosome, showing a significant difference between them. While in the patients of trisomy 8, it was 73.08% (19/26), which was parallel to that in the patients with normal chromosome. Conclusion: The effectiveness of QHP+BPYS comprehensive therapy for MDS is unquestionably good, and it is markedly correlated with the FAB type and IPSS risk degree of the disease, as well as the normality of chromosome in the patient.