非那雄胺联合经尿道1470 nm半导体激光气化切除中重度前列腺增生的安全性和有效性

摘要

目的 研究非那雄胺联合经尿道1470 nm半导体激光气化切除中重度良性前列腺增生症(BPH)的安全性和有效性.方法 连续选择2015年1月~12月入本院首次诊断中重度BPH患者共110例,随机分为对照组和观察组,各55例,对照组采用非那雄胺联合经尿道前列腺切除术(TURP),观察组采用非那雄胺联合1470 nm半导体激光气化切除术,对比手术成功率、并发症发生率、平均手术时间、术中及术后出血量、留置导尿管时间,术前和术后前列腺体积,随访12.0个月,比较国际前列腺症状评分(I-PSS)、生活质量评分(QOL)、最大尿流率(Qmax)和残余尿量(PVR)的差异性.结果 两组手术成功率比较差异无统计学意义,观察组的并发症发生率低于对照组(P<0.05).两组手术时间和留置导尿管时间比较差异无统计学意义,观察组的出血量和术后前列腺体积明显小于对照组,前列腺体积差值增加(P<0.05).两组术后随访I-PSS值降低,QOL值升高,Qmax升高,PVR值降低,观察组比对照组改善更明显(P<0.05).结论 非那雄胺联合经尿道1470 nm半导体激光气化切除中重度BPH有较好的安全性和有效性,优于TURP.%Objective To study the safety and effectiveness finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe benign prostatic hyperplasia (BPH). Methods A total of 110 consecutives from January to December 2015 were divided randomly into control and observation groups and each of 55 cases; the patients in control group received finasteride combined with transurethral prostatectomy (TURP) and they in observation group adopted finasteride combined with 1470 nm semiconductor laser vaporization and resection, then to compare the differences of surgical success rate,complications rate,mean operation time,blood bloss during and after operation, indwelling catheter time,prostate volume before and after operation; the follow-up time was 12.0 months, the differences of international prostate symptom score (I-PSS), Quality of life score (QOL), peak flow rate (Qmax) peak flow rate (Qmax) and post-void residual (PVR). Results The surgical success rate in the two groups were no statistical difference, the complications rate in observation group was significantly lower (P<0.05). The mean operation time and indwelling catheter time in the two groups were no statistical difference, while the total blood bloss and prostate volume after operation in observation group were both less, and the difference of prostate volume was more (P<0.05). The I-PSS and PVR were lower, QOL and Qmax higher in the two groups after operation, what'more, there were more improvements in observation group (P<0.05). Conclusion It is more prior to finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe BPH on the Safety and effectiveness than TURP.