直光束绿激光前列腺汽化术治疗良性前列腺增生的疗效分析

目的 总结经尿道选择性160W直光束绿激光前列腺汽化术(直光束PVP)治疗良性前列腺增生(BPH)的手术方法、疗效和安全性，并与经尿道前列腺电切术(TURP)进行对比。方法 将58例BPH患者随机分为2组，其中28例行直光束PVP，30例行TURP，比较2组患者的手术时间、术中出血量、膀胱冲洗时间、留置尿管时间、住院时间、术前术后残余尿(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)及近期并发症等相关指标。结果 所有手术均顺利完成，未发生严重并发症。直光束PVP组的术中出血量明显少于TURP组(P<0.05)，同时膀胱冲洗时间、术后留置尿管时间及住院时间明显短于TURP组(P<0.05)；其手术时间略大于TURP组，但差异无统计学意义(P>0.05)。2组患者术后IPSS、QOL、Qmax及RUV等指标较术前均有明显改善(P<0.05)，但组间比较差异无统计学意义(P>0.05)。术后随访6个月，2组近期并发症无明显差异。结论 直光束PVP治疗BPH具有术中出血少、手术安全性高及住院时间短等优点，可作为治疗BPH的一种理想的手术方法。

Effect of straight light beam greenlight PVP for the treatment of benign prostatic hyperplasia

Objective To summarize the method, effect and safety of 160W straight light beam greenlight photoselective vaporization of prostate (PVP)in the treatment of benign prostate hyperplasia(BPH), and compare it with transurethral resection of prostate (TURP). Methods 58 cases of BPH were randomly treated with 160W straight light beam greenlight PVP(n=28), or treated with TURP (n=30). All patients were followed up with operative time, hemorrhage volume during surgery, bladder irrigation time, catheter indwelling time, hospital stay time, residual urine volume(RUV)， international prostatic symptom score(IPSS), quality of life(QOL), maxmium flow rates(Qmax), and operative complications. Results All operations were successfully completed, and no severe complicaton occured. A significant difference in favor of straight light beam greenlight PVP was achieved for the bladder irrigation time, catheter indwelling time, hospital stay time and hemorrhage volume during surgery(P<0.05). A slight but not significant difference was found in operating time (P>0.05). The IPSS, QOL, Qmax and RUV were significantly improved in both groups after operations(P<0.05), but no significant differrence in the improvement of the subjective symptom and objective signs were found between the 2 groups(P>0.05). A 6-months followed-up indicates postoperative complications between the 2 groups were similar. Conclusion The results of our study show that 160W straight light beam greenlight PVP for the treatment of BPH has the advantage of fewer blood loss, safer surgical procedures and shorter hospital stay time.It may be an ideal operation method for the treatment of BPH.