不同功率绿激光与TURP治疗高危良性前列腺增生症的对比研究

发布时间：2019-06-03 04:17

【摘要】：目的:通过160W PVP和80W PVP与TURP治疗高危良性前列腺增生症的对比分析,探讨经尿道160W绿激光前列腺汽化术治疗高危BPH的安全性及临床疗效。方法:选取2013年9月至2016年3月在我院治疗的有一种及以上重要脏器合并症的老年良性BPH患者180例,随机分配3组(160W PVP组、80W PVP组、TURP组),每组60例。手术前后检测血红蛋白、血钠水平;术后随访6个月,检测术前及术后最大尿流率(Qmax)、残余尿量(PVR),并行国际前列腺症状评分(IPSS)、生活质量评分(QOL),记录术后不良反应、留置尿管时间、住院时间及近期并发症的发生情况。结果:手术均顺利完成,随访6个月,无失访者。三组患者的平均年龄和前列腺的平均体积无统计学差异(P均0.05)。三组患者术前、术后的TPSS、Qmax、PVR、QOL观察指标比较均有统计学差异(P均 0.05)。三组的手术前后血红蛋白的变化、平均手术时间比较均有统计学差异(P均 0.05)。160WPVP组和80W PVP组的术中血清钠的变化、术后留置尿管时间、住院时间的比较无统计学差异(P0.05),但与TURP组比较均有统计学差异(P 0.05)。所有患者均未输血,无前列腺包膜穿孔,无电切综合征发生。术后无尿失禁、继发性出血。随访期内疗效满意。结论:160W PVP和80W PVP与TURP相比都能有效地减轻前列腺增生症患者的下尿路症状、改善生活质量,疗效相当。同时PVP相对于TURP具有出血少、安全性高的优点,尤其新一代高功率160WPVP治疗良性前列腺增生症,术中出血更少、效率更高、手术更快,尤其适合合并内科疾病、耐受力较差的高危BPH患者。
[Abstract]:Objective: to compare 160W PVP and 80W PVP with TURP in the treatment of high risk benign prostatic hyperplasia (BPH), and to investigate the safety and clinical efficacy of transurethral 160W green laser vaporization of prostate in the treatment of high risk BPH. Methods: from September 2013 to March 2016, 180 elderly patients with benign BPH with one or more important organ complications were randomly assigned to three groups (160W PVP group, 80W PVP group, TURP group) with 60 cases in each group. Hemoglobin and serum sodium levels were measured before and after operation. The patients were followed up for 6 months. The maximum urinary flow rate (Qmax),) residual urine volume (PVR),) and international prostate symptom score (IPSS),) quality of life score (QOL),) were measured before and after operation, and the postoperative adverse reactions and indwelling catheter time were recorded. Length of stay in hospital and occurrence of recent complications. Results: the operations were successfully completed and followed up for 6 months. There was no significant difference in the average age and the mean volume of prostate among the three groups (P 0.05). There were significant differences in TPSS,Qmax,PVR,QOL between the three groups before and after operation. There were significant differences in the changes of hemoglobin and the average operation time between the three groups before and after operation. The changes of serum sodium during operation and the time of indwelling catheter in 160WPVP group and 80W PVP group were significantly different. There was no significant difference in hospitalization time (P 0.05), but there was significant difference with TURP group (P 0.05). No blood transfusion, no prostate capsule perforation and no electroresection syndrome occurred in all patients. There was no urinary incontinence and secondary bleeding after operation. The curative effect was satisfactory during the follow-up period. Conclusion: 160W PVP and 80W PVP can effectively reduce the lower urinary tract symptoms and improve the quality of life in patients with benign prostatic hyperplasia compared with TURP. At the same time, PVP has the advantages of less bleeding and higher safety compared with TURP. Especially, the new generation of high power 160WPVP in the treatment of benign prostatic hyperplasia (BPH) has less intraoperative bleeding, higher efficiency and faster operation, which is especially suitable for medical diseases. High risk BPH patients with poor tolerance.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R699.8

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