980 nm二极管激光与等离子经尿道前列腺剜除术治疗良性前列腺增生的应用比较

目的：比较980 nm二极管激光与等离子在经尿道前列腺剜除术治疗良性前列腺增生中的安全性、有效性及术后随访结果。方法将64例良性前列腺增生的患者随机分为两组，分别采用980 nm二极管激光（激光组）或等离子（等离子组）经尿道前列腺剜除术，比较两组患者年龄、前列腺大小、手术时间、术中出血量以及术前术后、电解质变化情况、前列腺症状评分、最大尿流率、残余尿量等。结果两组患者年龄、前列腺大小、术前前列腺症状评分、最大尿流率、残余尿量等指标差异无统计学意义（P＞0．05）。激光组手术时间（68±15．4）min，术后血红蛋白下降（4．8±1．0）g／L，患者术后平均留置导尿时间3?1 d。等离子组手术时间（81．2±16．9）min，术后血红蛋白下降（8．6±1．8）g／L，患者术后平均留置导尿时间5．6 d。两组相比，差异有统计学意义（ P＜0．05），表明激光组均优于等离子组。两组患者术前术后电解质Na＋下降无统计学意义（ P＞0．05）。与术前相比，两组术后第1、6个月前列腺症状评分、最大尿流率、残余尿量等指标差异均有统计学意义（ P＜0．05）。两组患者均顺利完成手术，无输血事件及电切综合征发生。结论980 nm二极管激光与等离子经尿道前列腺剜除术治疗良性前列腺增生，均安全有效，但980 nm二极管激光血红蛋白下降更少，手术时间和留置导尿管时间更短。

Comparison of the diode laser and the transurethral plasmakinetic enucleation of the prostate for treatment of benign prostatic hyperplasia

Objective To compare the validity and safety of diode laser and transurethral plasmakinetic enucleation of the pros?tate in benign prostatic hyperplasia ( BPH) patients. Methods 64 BPH patients treated with transurethral enucleation of the prostate were divided randomly into 2 groups by diode laser ( diode laser group) or plasma kinetic ( plasma group) respectively. Patients' age, prostate size, operation time, intraoperative blood loss, preoperative and postoperative changes of electrolyte, prostate symptom score, maximum urinary flow rate and residual urine volume of the two groups were recorded and compared. Results There was no statistically significant difference in patients'age, size of the prostate, preoperative prostate symptom score, maximum urinary flow rate and residual urine volume of two groups (P>0.05). Laser group average operation time was (68±15.4)min, postoperative hemoglobin decreased to (4.8±1.0)g/L, and average postoperatively in patients with indwelling catheter time was 3.1 d. Plasma group average operation time was (81.2±16.9)min, postoperative hemoglobin dropped to (8.6±1.8)g/L, average postoperatively in patients with indwelling catheter time was 5.6 d. There was statistically significant difference (P<0.05), indicating that the laser group were better than plasma group. Two groups of patients with preoperative postoperative electrolyte Na+ was not significantly different (P>0.05). Compared with the preopera?tive, two groups of 1, 6 months after prostate symptom score, maximum urinary flow rate, residual urine volume indicators such differ?ences were significant different ( P<0.05) . Two groups of patients were successfully completed surgery without blood transfusion and cut?ting syndrome. Conclusion 980 nm diode laser and transurethral plasmakinetic enucleation of the prostate in the treatment of benign prostatic hyperplasia are safe and effective, but hemoglobin decreased less, indwelling catheter time is shorter with 980 nm diode laser.