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目的评价经尿道前列腺等离子气化电切术(PKVP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生症(BPH)的疗效以及安全性。方法搜集世界范围内运用PKVP与TURP治疗BPH随机对照试验(RCT)、非随机对照试验(NRCT)和回顾性对照试验的英文及中文文献,并追查已纳入文献的参考文献。计算机检索:Pubmed,Ovid,ScineceDirect,NGC,EBSCO,EMBASE,CNKI,CBM;手工检索:《中华泌尿外科杂志》、《临床泌尿外科杂志》、《中国男科学杂志》、《中华男科学杂志》等四种相关杂志。由两位系统评价员做独立文献筛查、质量评价和资料提取,并交叉核对,不同意见时经过讨论或请第三者裁决。使用统计软件Rev Man5.0完成Meta分析。结果经筛选,最后纳入13篇文献,包括受试患者1977例,进行Meta分析,其基线情况具有可比性。通过比较分析两种术式的相关效应指标及不良反应和并发症得出:PKVP的手术时间、术中出血量、置尿管时间和住院时间均短于TURP(p<0.05),PKVP术后尿道狭窄、TUR综合征和继发性出血的发生率较TURP低,差异均有统计学意义。结论Meta分析显示两种腔道手术均是治疗BPH的有效方法,但PKVP的手术时间、术中出血量、置尿管时间和住院时间均短于TURP,且可降低尿道狭窄、TUR综合征和继发性出血的发生率。说明PKVP相比TURP是安全、有效的,可根据病人的病情、经济能力、术者的经验和医院的条件决定术式。
Objective To evaluate the efficacy and safety of transurethral vaporization of the prostate (PKVP) and transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). Methods We collected English and Chinese documents from the randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs) and retrospective controlled trials of PKVP and TURP worldwide and traced the references that have been included in the literature. Computer searches: Pubmed, Ovid, ScineceDirect, NGC, EBSCO, EMBASE, CNKI, CBM; Manual search: Chinese Journal of Urology, Journal of Clinical Urology, Chinese Journal of Chinese Medicine, Chinese Journal of Ophthalmology, etc. Four related magazines. The two system reviewers do independent literature screening, quality evaluation and data extraction, and cross-check, disagree with the discussion or a third party ruling. Meta-analysis was done using statistical software RevMan5.0. The results were screened, and finally included in 13 articles, including 1977 patients in the trial, Meta analysis, the baseline conditions were comparable. By comparative analysis of the two indicators of surgical effects and adverse reactions and complications: PKVP surgery time, blood loss, catheterization and hospital stay were shorter than TURP (p <0.05), after PKVP The incidence of urethral stricture, TUR syndrome and secondary bleeding was lower than that of TURP, the differences were statistically significant. Conclusions Meta-analysis shows that both kinds of tunnel surgery are effective methods for the treatment of BPH. However, the operation time, intraoperative blood loss, catheterization and hospital stay of PKVP are shorter than TURP, and can reduce urethral stricture, TUR syndrome and The incidence of secondary bleeding. Description PKVP compared TURP is safe and effective, according to the patient’s condition, financial ability, the surgeon’s experience and hospital conditions determine the operation.