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目的:比较绿激光解剖性汽化切除术（AVIT）和选择性光汽化术（PVP）治疗良性前列腺增生的效果与安全性。方法:纳入2019年11月至2020年9月在苏州大学附属第二医院接受前列腺绿激光手术的患者136例，年龄53~85岁。前列腺体积30~104 ml。采用随机数字表法分成两组，其中68例行AVIT（纳入观察组），68例行PVP（纳入对照组）。收集两组患者术前、术中及术后的临床资料，并进行比较分析。结果:两组手术均顺利完成。术后6个月，观察组和对照组分别有63例和66例完成随访。两组患者术前高血压、糖尿病、冠状动脉粥样硬化性心脏病、心房颤动及肾功能不全的患病率差异均无统计学意义（均n P>0.05）。两组患者术前年龄［（66.8±6.5）比（67.3±5.4）岁］、国际前列腺症状评分（IPSS）［（24.2±4.7）比（23.5±4.5）分］、生活质量评分（QOL）［4.7（4.1，4.9）比 4.6（4.2，5.0）分］、最大尿流率（Qmax）［（6.9±2.8）比（6.8±2.6）ml/s］、残余尿量（PVR）［（137（52.8，190.9）比119（70.6，172.1）ml］、前列腺体积（PV）［70.5（60.6，80.9）比68.2（61.2，80.5）ml］、血清前列腺特异性抗原（PSA）［4.4（3.5，5.1）比4.4（3.4，5.0）ng/ml］差异均无统计学意义（均n P>0.05）。两组患者术中出血量、术后留置尿管时间和术后住院时间差异均无统计学意义（均n P>0.05）。相比对照组，观察组手术时间和激光持续时间更长［69.0（64.6，75.0）比55.8（49.1，63.4）min，（36.3±9.9）比（31.3±9.3）min］，术中激光能耗与能量密度更高［（297±20）比（240±20）kJ，（4.50±1.35）比（3.73±1.17）kJ/ml］，差异均有统计学意义（均n P0.05). The differences of preoperative age [(66.8±6.5) vs (67.3±5.4) years], international prostate symptom score (IPSS) [(24.2±4.7) vs (23.5±4.5) ], quality of life score (QOL) [4.7(4.1, 4.9) vs 4.6(4.2, 5.0)], peak urinary flow rate (Qmax) [(6.9±2.8) vs (6. 8±2.6) ml/s], post-void residual volume (PVR) [(137(52.8, 190.9) vs 119(70.6, 172.1) ml], prostate volume (PV) [70.5(60.6, 80.9) vs 68.2(61.2, 80.5) ml], serum prostate specific antigen (PSA) [4.4(3.5, 5.1) vs 4.4(3.4, 5.0) ng/ml] were not statistically significant between the two groups (alln P>0.05). There was no significant difference in the amount of intraoperative blood loss, catheterization time and the postoperative hospitalization time between the two groups (all n P>0.05). Compared with the control group, the operation time and lasing time of the observation group were longer[69.0(64.6, 75.0) vs 55.8(49.1, 63.4) min,(36.3±9.9) vs (31.3±9.3) min], and the intraoperaive laser energy consumption and laser energy density were higher[(297±20) vs (240±20) kJ,(4.50±1.35) vs (3.73±1.17) kJ/ml]. The differences were all statistically significant (alln P<0.05). At the follow-up of 1, 3 and 6 months after operation, IPSS and QOL in the observation group were lower than those in the control group, and the differences were all statistically significant (all n P<0.05). Qmax in the observation group was higher and PVR was lower than those in the control group, with statistically significant differences (n P<0.05). Six months after operation, PV and PSA in the observation group decreased more significantly than those in the control group (56% vs 47%, 70% vs 60%, bothn P<0.05). No urethral stricture and urinary incontinence occurred in two groups after operation. The incidence rate of urinary tract irritation in the observation group was 6.3%(4/63),lower than the 18.2%(12/66)in the control group (n P0.05).n Conclusions:Greenlight laser anatomical vaporization-incision technique is safe and effective in the treatment of BPH. Compared with PVP, AVIT has more prostate tissue removed and better curative effect, which is worthy of clinical promotion.