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目的:观察比较经尿道120W绿激光汽化术与等离子电切术治疗前列腺增生症的临床疗效。方法:选择确诊的良性前列腺增生症79例,根据手术方式分为经尿道120W前列腺绿激光汽化术组(PVP组)42例和前列腺等离子电切术组(TUPKRP组)37例。比较两组手术时间、术中出血量、膀胱冲洗时间及术中冲洗液用量、留置导尿管时间、住院时间、手术前后症状改善以及近期并发症发生情况。结果:PVP组手术时间、冲洗液用量均长(多)于TUPKRP组,术中出血量、术后膀胱冲洗时间、留置尿管时间及住院时间均显著少(短)于TUPKRP组(P<0.05)。术后3个月,两组国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)均较本组术前显著或非常显著降低(P<0.05,P<0.01),最大尿流率(Qmax)较术前非常显著增加(P<0.01);术后两组组间上述各项指标比较均差异不显著(P>0.05)。两组术后近期并发症发生率差异不显著(P>0.05)。结论:PVP与TUPKRP治疗良性前列腺增生症临床疗效相当,PVP较TURPK术中出血量少、术后留置导尿管时间短、恢复快。
Objective: To observe and compare the clinical efficacy of transurethral 120W green laser vaporization and plasma resection in the treatment of benign prostatic hyperplasia. Methods: A total of 79 cases of benign prostatic hyperplasia (BPH) were selected and divided into transurethral PVW group (42 cases) and prostatic plasma membrane excision group (TUPKRP group) according to the operation mode. The operation time, intraoperative blood loss, bladder irrigation time and amount of irrigation fluid, indwelling catheter time, hospital stay, symptoms before and after surgery and recent complications were compared between the two groups. Results: The operation time and volume of irrigating fluid in PVP group were both longer and more in TUPKRP group than those in TUPKRP group (P <0.05), the amount of bleeding during operation, postoperative bladder irrigation time, indwelling catheter time and hospitalization time were significantly less (P <0.05) ). At 3 months after operation, the scores of IPSS, QOL and PVR in both groups were significantly lower than those before operation (P <0.05, P <0.01) The maximum flow rate (Qmax) was significantly higher than that before operation (P <0.01). There was no significant difference between the two groups after operation (P> 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusion: The clinical efficacy of PVP and TUPKRP in the treatment of benign prostatic hyperplasia is similar. PVP has less blood loss than TURPK, shorter postoperative catheterization and faster recovery.