“点-线-面”三步法直出绿激光前列腺汽化切除术治疗良性前列腺增生疗效观察

摘要

目的 探讨“点-线-面”三步法直出绿激光前列腺汽化切除术(PVRP)治疗良性前列腺增生(BPH)的临床疗效及安全性.方法 回顾性分析2016年5月至2017年8月新乡医学院第一附属医院手术治疗的126例BPH患者的临床资料,其中行“点-线-面”三步法直出PVRP治疗者69例(PVRP组),行选择性前列腺绿激光汽化术(PVP)治疗者57例(PVP组),比较2组患者手术时间、术中出血量、术后膀胱冲洗时间、术后导尿管留置时间、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)及术后并发症.结果 PVRP组患者手术时间短于PVP组(P＜0.05);2组患者术中出血量、术后膀胱冲洗时间、导尿管留置时间比较差异无统计学意义(P＜0.05).2组患者术前IPSS、QOL、Qmax、PVR比较差异无统计学意义(P＜0.05).2组患者术后IPSS、QOL、PVR低于术前(P＜0.05),Qmax高于术前(P＜0.05);2组患者术后IPSS、QOL、Qmax、PVR比较差异无统计学意义(P＜0.05).PVRP组和PVP组患者术后并发症发生率分别为1.4％ (1/69)、1.8％ (1/57),2组患者术后并发症发生率比较差异无统计学意义(x2=11.968,P＜0.05).结论 “点-线-面”三步法直出PVRP治疗BPH步骤简单,手术时间短,是一种安全理想的治疗BPH的手术方式.%Objeodve To discuss the safety and efficacy of " point-line-surface" three step method of straight light beam green laser photoselective vaporesection of the prostate(PVRP) for the treatment of benign prostatic hyperplasia(BPH).Methods The data of one hundred and twenty-six BPH patients who were treated with surgery in the First Affiliated Hospital of Xinxiang Medical University from May 2016 to August 2017 was analyzed retrospective.In all of the patients,69 cases were given "point-line-surface" three step method of straight light beam green laser PVRP(PVRP group),57 cases were given photoselective vaporization of the prostate (PVP group).Operation time,blood loss,postoperative washing time,indwelling catheter time,international prostate symptom score (IPSS),quality of life score (QOL),maximum urinary flow rate (Qmax) and postvoid residual urine (PVR) were compared between the two groups.Results The operation time in the PVRP group was shorter than that in the PVP group(P ＜ 0.05).There was no significant difference in the blood loss,postoperative washing time and indwelling catheter time between the PVRP group and PVP group(P ＜ 0.05).There was no significant difference in the IPSS,QOL,Qmax and PVR between the PVRP group and PVP group before operation (P ＜ 0.05).In the two groups,the IPSS,QOL and PVR were lower after operation than that before operation (P ＜ 0.05),while Qmax was higher after operation than that before operation(P ＜ 0.05).There was no significant difference in the IPSS,QOL,Qmax and PVR between the PVRP group and PVP group after operation(P ＜ 0.05).The rate of postoperative complications in the PVRP group and PVP group was 1.4％(1/69) and 1.8％ (1/57),respectively;there was no significant difference in the rate of postoperative complications between the PVRP group and PVP group (x2 =11.968,P ＜ 0.05).Conclusion " Point-line-surface" three steps of straight light of PVRP for treating BPH have simple steps and short operation time.It is a safe and ideal surgical method for BPH.