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目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(5-ARIs)(持续时间>1个月)以及有无既往急性尿潴留史(AUR)进行分组对照研究,观察记录术前及围手术期情况,并于术后1、3个月随访。结果:共174例患者纳入研究,38例患者术中转为经尿道前列腺电切术(TURP),其余136例患者顺利完成手术并随访至术后3个月。患者年龄(69.4±7.7)岁,术前PV(67.9±29.8)ml,手术时间(49.4±16.3)min。术中无输血、电切综合征及前列腺包膜穿孔发生,术后2例患者发生尿道狭窄、2例患者出现膀胱颈口挛缩。各组患者的术后疗效指标均较术前显著提高,且各对照组间(大体积前列腺组与非大体积前列腺组、5-ARIs服用组与5-ARIs未服用组、AUR病史组与无AUR病史组)无统计学差异。结论:120 W PVP治疗BPH安全有效,且疗效不受PV、术前是否规律服用5-ARIs、既往有无AUR史影响,但术前留置导尿管可能增加手术难度及术中中转TURP的风险。
Objective: To compare the efficacy and safety of 120 W green laser prostatic vaporization (PVP) in patients with benign prostatic hyperplasia (BPH). Methods: From July 2013 to September 2014 in our department diagnosed with BPH in parallel with 120 W PVP patients, according to the volume of the prostate (PV) (<80 ml and ≥ 80 ml), with or without 5-α-reductase inhibition (5-ARIs) (duration> 1 month) and the history of previous acute urinary retention (AUR) were grouped and controlled. The preoperative and perioperative conditions were observed and recorded. The patients were followed up for 1 and 3 months . RESULTS: A total of 174 patients were enrolled in the study. Thirty-eight patients underwent transurethral resection of the prostate (TURP). The remaining 136 patients completed the procedure and were followed up for 3 months. The patient’s age (69.4 ± 7.7) years, preoperative PV (67.9 ± 29.8) ml, operation time (49.4 ± 16.3) min. No intraoperative blood transfusion, resection syndrome and prostatic capsular perforation occurred in 2 patients with urethral stricture occurred in 2 patients with bladder neck contracture. The curative effect index of each group was significantly higher than that before operation, and there was no significant difference between the control group (large volume prostate group and non-large volume prostate group, 5-ARIs taking group and 5-ARIs non-taking group, AUR history group and none AUR history group) no significant difference. CONCLUSIONS: 120 W PVP is safe and effective in the treatment of BPH, and its efficacy is not affected by PV. Whether 5-ARIs are regularly taken before surgery or not has no history of AUR, but preoperative catheterization may increase the difficulty of operation and the risk of intraoperative transfer of TURP .