绿激光各术式治疗前列腺增生的差异研究

目的比较绿激光各种术式治疗前列腺增生的安全性及有效性。方法回顾性对比分析本院自2016年5月至2018年5月2年内绿激光各种术式,包括绿激光前列腺汽化术(GL-PVP)、绿激光前列腺汽化切割术(GL-PVRP)、绿激光前列腺剜除术(GEL-EP)治疗前列腺的手术时间、出血量、膀胱冲洗时间、术后导尿管留置时间等近期临床指标。对于术后3个月随访的尿流动力学数据、术后国际前列腺症状评分(IPSS)评分改变值、术后生活质量评分(QOL)评分改变值、国际勃起功能指数问卷调查表评分(IIEF评分)差值、术后并发症等远期临床指标进行组间分析。结果GL-PVP组、GL-PVRP组、GEL-EP组患者的术前一般数据年龄、术前前列腺体积、术前前列腺特异性抗原(PSA)、术前IPSS评分、术前QOL评分、术前最大尿流率(Qmax)、术前膀胱残余尿(PUR)、IIEF之间]差异无统计学意义(P>0.05)。相比术前,患者在术后最大尿流率(Qmax)、术后膀胱残余尿(PUR)、术后IPSS评分、术后QOL评分改善较术前差异均有统计学意义(P<0.01)。组间比较中,PVP、PVRP、EP三种术式治疗BPH的平均手术时间、术中平均出血量、持续膀胱冲洗时间、留置导尿管时间比较,差异有统计学意义(P<0.05)。而在术后IPSS改变值、术后QOL改变值、尿流率改变值、膀胱残余尿改变值、国际勃起功能指数问卷调查表评分差值、术后并发症发生率等方面差异无统计学意义(P>0.05)。结论绿激光可以有效地、安全地治疗前列腺增生,相比PVRP及GL-EP术,PVP术手术时间更短,术中出血量更少,术后膀胱冲洗时间更短,留置尿管时间更短。

Study on the difference of green laser in the treatment of prostatic hyperplasia

Objective To compare the safety and efficacy of different green laser surgery in the treatment of benign prostatic hyperplasia.Methods A retrospective comparative analysis was made of the data of patients who underwent various green laser prostatectomy(GL-PVP),green laser vaporization of the prostate(GL-PVRP)and green laser enucleation of the prostate(GEL-EP)in our hospital during May 2016 and May 2018.The short-term clinical indexes such as operation time,bleeding volume,bladder irrigation time and indwelling time of urethral catheter after prostatectomy were compared and analyzed.The long-term clinical data,such as urodynamic data,postoperative IPSS score,postoperative QOL score,international erectile function index questionnaire score,postoperative complications were analyzed between groups.Results There was no statistically significant difference between preoperative general data(age,preoperative prostate volume,preoperative PSA,preoperative IPSS score,preoperative QOL score,preoperative maximum urine flow rate,preoperative residual bladder urine,international erectile function index questionnaire score)of patients in GL-PVP group,GL-PVRP group and GEL-EP group(P>0.05).Compared with the preoperative patients in postoperative maximum urinary flow rate,postoperative bladder residual urine,postoperative IPSS score,postoperative QOL scores improved were statistically significant(P<0.01).The mean operative time of PVP,PVRP and EP in BPH treatment,.intraoperative mean blood loss,duration of continuous bladder irrigation and indwelling catheter time were statistically significant(P<0.05).However,there was no statistically significant difference in postoperative IPSS change value,postoperative QOL change value,urinary flow rate change value,and bladder residual urine change value,international erectile function index questionnaire score change value and incidence of postoperative complications.Conclusions Green laser can effectively and safely treat prostatic hyperplasia.Compared with PVRP and GL-EP,PVP has advantages of shorter operative time,less intraoperative blood loss,shorter postoperative bladder rinsing time and shorter time of indwelling urinary catheter.