980nm半导体红激光前列腺汽化术与经尿道前列腺电切术治疗良性前列腺增生的临床疗效比较

发布时间：2019-03-01 17:10

【摘要】：目的本研究主要是总结980nm半导体红激光前列腺汽化术在治疗良性前列腺增生（Benign prostatic hyperplasia, BPH)方面的临床疗效及手术情况，并与经尿道电切术（Transurethral prostatic resection, TURP）进行综合分析比较，探讨980nm半导体红激光前列腺汽化术治疗BPH的安全性及疗效，为今后980nm半导体红激光在BPH方面的临床应用提供科学依据。方法采集自2012年4月至2013年4月期间在河北联合大学附属医院泌尿外科住院并接受980nm半导体红激光治疗或TURP治疗的BPH患者，，随机分成两组，其中87例接受980nm半导体红激光前列腺汽化术，81例接受TURP治疗。观察记录两组患者的手术时间、术中出血量、术后并发症，术前及术后分别进行国际前列腺症状评分(IPSS)、生活质量指数评分（QOL）、最大尿流率（Qmax）、残余尿量（PVR）等指标的差异有无统计学意义，并进行综合分析比较。结果两组患者的年龄、病程、前列腺体积、PVR、Qmax、IPSS、QOL、血钠值、血红蛋白值等术前情况进行比较，差异无统计学意义（P＞0.05）；980nm激光组手术时间大于TURP组，差异有统计学意义（P＜0.05）；980nm激光组术中失血量、术后膀胱冲洗时间、留置尿管时间以及术后住院时间均明显少于TURP组，差异有统计学意义（P＜0.01）；980nm激光组术后继发出血、TURS综合症少于TURP组，差异有统计学意义（P＜0.05）；与术前症状相比较，两组患者术后较术前有显著差异，差异有统计学意义（P＜0.01）；两组患者术后疗效比较，差异无统计学意义（P＞0.05），说明两组患者术后疗效相同。结论980nm半导体红激光前列腺汽化术能明显改善患者的下尿路梗阻症状，具有与TURP相同的近期疗效，与TURP相比，具有手术操作简单、术中出血少、术后留置尿管时间及住院时间短、术后恢复快等优点，是一种治疗BPH安全有效的微创手术方式。
[Abstract]:Objective the purpose of this study was to summarize the clinical efficacy and surgical results of 980nm semiconductor red laser vaporization of prostate in the treatment of benign prostatic hyperplasia (Benign prostatic hyperplasia, BPH) and to compare it with transurethral resection of the prostate (Transurethral prostatic resection, TURP). To investigate the safety and efficacy of 980nm semiconductor red laser vaporization of prostate in the treatment of BPH, and to provide scientific basis for the clinical application of 980nm semiconductor red laser in BPH in the future. Methods from April 2012 to April 2013, BPH patients who were hospitalized in urological department of affiliated Hospital of Hebei Union University and received 980nm semiconductor red laser therapy or TURP treatment were randomly divided into two groups. Among them 87 cases were treated with 980nm semiconductor red laser vaporization of prostate and 81 cases were treated with TURP. The time of operation, the amount of bleeding during operation, the postoperative complications, the (IPSS), quality of life index (QOL),) and the (Qmax), (International Prostate symptom score) before and after operation were observed and recorded in the two groups. The difference of residual urine volume (PVR) and other indexes was statistically significant, and comprehensive analysis and comparison were carried out. Results there was no significant difference between the two groups in age, course of disease, prostate volume, serum sodium level of PVR,Qmax,IPSS,QOL, and hemoglobin value before operation (P > 0. 05), but no significant difference was found between the two groups (P > 0. 05). The operation time of 980nm laser group was longer than that of TURP group (P < 0 05). The blood loss, bladder irrigation time, indwelling catheter time and postoperative hospitalization time in 980nm laser group were significantly lower than those in TURP group (P < 0 01). TURS syndrome in 980nm laser group was significantly lower than that in TURP group (P < 0 05), and there was significant difference between the two groups in postoperative symptoms (P < 0 01), but there was no significant difference between the two groups (P < 0 05). There was no significant difference in postoperative curative effect between the two groups (P > 0.05), indicating that the two groups had the same postoperative curative effect. Conclusion 980nm semiconductor red laser vaporization of prostate can significantly improve the symptoms of lower urinary tract obstruction, and has the same short-term curative effect as TURP. Compared with TURP, it has simple operation and less bleeding during operation. It is a safe and effective minimally invasive operation for BPH due to its short time of indwelling catheter, short hospitalization time and quick recovery after operation.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699.8

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