选择性绿激光前列腺汽化术与前列腺电切术治疗高危良性前列腺增生症的临床疗效对照研究

目的：比较选择性绿激光前列腺汽化术（PVP）与前列腺电切术（TtIRP）治疗高危良性前列腺增生症的临床疗效。方法：将90例具有手术指征的前列腺增生症患者随机分为每组45例的PVP组（观察组）和TuRP组（对照组），分别施以PVP术式和TURP术式。比较其两组平均手术时间、术后平均膀胱冲洗时间、术后留置导尿管时间、手术出血量、住院时间、残余尿量、最大利尿率、手术并发症、术前后国际前列腺症状评分（IPSS）及术前后生活质量评分（QOL）等指标的差异。结果：①观察组在术后平均膀胱冲洗时间、术后留置导尿管时间、手术出血量及住院时间明显低于对照组（P〈0．01）；②两组患者术前最大尿流率、IPSS、QOL评分等比较没有显著差异性（P〉0．05）；与术前比较，两组患者术后各项指标均得到明显改善（P〈0．01），而两组患者术后各项指标比较无显著差异性（P〉0．05），两种术式疗效相似；③两组电切综合症发生率比较无显著差异性（P〉0．05），观察组患者术后尿失禁、血尿、性功能障碍发生率明显低于对照组患者（P〈0．05），但观察组患者尿潴留发生率较对照组要高（P〈0．05）。结论：PVP能有效治疗高危良性前列腺增生症，与TURP相比，具有术中出血少、低并发症、操作安全、术后恢复快等优点。

Clinical efficacy of photoselective vaporization of the prostate and transurethral resection of prostate on the treatment of high - risk benign prostatic hyperplasia

Objectives： To compare the clinical efficacy between photoselective vaporization of the prostate （PVP） and transurethral resection of prostate （TURP） in the treatment of high risk benign prostatic hyperplasia. Method ： 90 patients with operation indications of benign prostatic hyperplasia were randomly divided into PVP Group （observation group） and TURP Group （control group） , with 45 cases in each group, respectively They were treated with PVP operation and TURP operation. Difference indexes of the two groups were compared including the average operation time, average postoperative bladder irrigation time, post operative indwelling catheter time, bleeding vdume during operation, hospitalization time, residual urine volume, maximum diu resis rate, complications before and after operation, International Prostate Symptom Score （IPSS） and Postoperative Quality of Life Score （QOL）. Results： 1. The mean bladder irrigating time, postoperative indwelling catheter time, amount of bleeding, operation and hospitalization time in the observation group was significantly lower than that in the control group （ P 〈 0. 01 ） ; 2. The indexes of the preoperative maximal urinary flow rate, IPSS, QOL scores did not differ significantly in the two groups （P 〉0.05） ; 3. The transurethral resection syndrome incidence rate in the two groups showed no significant difference （P 〉0.05） ; The postoperative urinary incontinence, hematuria, sexual dysfunction of patients in the observation group was significantly lower than that of patients in the control group （P 〈0.05） while the incidence of urinary retention of the patients in the observation group was higherthan that in the control group （ P 〈 O. 05 ）. Conclusion： PVP is effective in the treatment of high - risk benign prostatic hyperpla- sia with less bleeding volume, less complications, more operation safety and better postoperative recovery.