论文部分内容阅读
目的比较经尿道2μm激光与等离子电切术治疗大体积前列腺增生的临床疗效及安全性。方法 87例前列腺体积>80mL前列腺增生患者,经尿道2μm激光前列腺剜除术治疗的47例为激光组,行离子电切术治疗的40例为电切组;比较2组手术时间、术中出血量、术后膀胱持续冲洗时间、导尿管留置时间、住院时间;观察2组手术前、后生活质量评分(quality of life,QOL)、国际前列腺症状评分(International Prostate Symptom Score,IPSS)、残余尿量(postvoid residual urine,PVRU)、最大尿流率(maximum urinary flow rate,Qmax)及术后并发症发生情况。结果 2组手术时间比较差异无统计学意义(P>0.05),激光组术中出血量[(59.2±15.3)mL]少于电切组[(91.3±14.6)mL],术后膀胱持续冲洗时间[(2.1±0.4)d]、导尿管留置时间[(3.9±0.8)d]、住院时间[(7.9±0.6)d]短于电切组[(2.9±0.6)d、(5.2±0.6)d、(9.5±0.4)d](P<0.05);激光组和电切组术后3个月QOL[(1.2±0.6)分、(1.4±0.7)分]、IPSS[(5.5±1.8)分、(5.6±1.5)分]低于术前[QOL(5.2±0.1)、(5.1±0.6)分,IPSS(25.5±2.5)、(24.8±3.3)分],PVRU[(16.8±8.4)mL、(17.2±9.2)mL]少于术前[(112.6±47.6)、(118.2±39.7)mL),Qmax[(5.3±1.5)mL/s、(5.0±1.1)mL/s]较术前减慢[Qmax(7.5±2.5)、(7.4±2.3)mL/s](P<0.05),但组间比较差异均无统计学意义(P>0.05);激光组术后并发症发生率(2.22%)低于电切组(29.73%)(P<0.05)。结论 2μm激光和离子电切均是治疗大体积前列腺增生的有效方法,2μm激光前列腺剜除术具有出血少、恢复快、并发症少等优点。
Objective To compare the clinical efficacy and safety of transurethral 2 μm laser and plasma tangential excision in the treatment of large-volume benign prostatic hyperplasia. Methods 87 cases of prostate volume> 80mL in patients with benign prostatic hyperplasia, transurethral resection of 2μm laser prostatectomy in 47 cases of laser group, 40 cases of iontophoresis were treated by cutting group; compared two groups of operation time, intraoperative bleeding The duration of bladder irrigation, the time of urinary catheter retention, and the duration of hospitalization. The quality of life (QOL), International Prostate Symptom Score (IPSS), residual Postvoid residual urine (PVRU), maximum urinary flow rate (Qmax) and postoperative complications. Results There was no significant difference in operative time between the two groups (P> 0.05). The intraoperative blood loss in the laser group (59.2 ± 15.3 mL) was less than that in the resection group (91.3 ± 14.6 mL) The duration of catheterization was (3.9 ± 0.8) days and the duration of catheterization was (2.1 ± 0.4) days, (7.9 ± 0.6) d and (1.2 ± 0.6) points, (1.4 ± 0.7) points), IPSS [(5.5 ± 0.4) d], (P <0.05) (5.6 ± 1.5) points lower than preoperative QOL (5.2 ± 0.1), (5.1 ± 0.6) points IPSS (25.5 ± 2.5) and (24.8 ± 3.3) points PVRU [(16.8 ± (5.3 ± 1.5) mL / s, (5.0 ± 1.1) mL / s] was significantly lower than that before operation [(112.6 ± 47.6), (118.2 ± 39.7) mL, (P <0.05), but there was no significant difference between the two groups (P> 0.05). The postoperative complications in the laser group were significantly lower than those in the preoperative group [Qmax (7.5 ± 2.5), (7.4 ± 2.3) mL / The incidence (2.22%) was lower than that in the resection group (29.73%) (P <0.05). Conclusion Both 2μm laser and iontography are effective methods for the treatment of large-volume benign prostatic hyperplasia. The 2μm laser prostatectomy has the advantages of less bleeding, quick recovery and less complications.