摘要
目的 探讨1.9 μm-VElA XL激光气化切除治疗良性前列腺增生症（BPH）的优越性.方法 收集本院采用经尿道1.9 μm-VElA XL激光气化切除术（VElA）治疗的良性前列腺增生共计36例,将该治疗方法的疗效与传统经尿道电气化切除术（TUPR）对比,观察患者术后国际前列腺症状评分（IPSS）、IPSS-QOL问卷、最大尿流率（Qmax）、残余尿量的变化情况,研究该方法的优越性.结果 本组中,VElA组和TURP组各36例.平均年龄为（63.1±9.1）岁和（64.7±10.2）岁.年龄、前列腺体积、前列腺特异性抗原浓度、最大尿流率（Qmax）、术前IPSS或术前最大尿流率（Qmax）两组之间差异无统计学意义.两组手术时间（P=0.36）相似.术后拔管时间在VElA和TURP组分别为（1.45 ±0.75）d和（2.63±0.49） d（P ＜0.01）,住院时间VElA组较TURP组缩短.TURP组和VElA组术后3个月最大尿流率分别提高到（9.90±3.61）和（6.59 ±6.06）mL/s,增加速度差异无统计学意义（P=0.08）.IPSS和IPSS-QOL术后显著改善（P＜0.01）,但两组改善差异无统计学意义（P＞0.05）.两组并发症发生率也相似.结论 VElA与TURP在BPH的治疗中,并发症发生率相似,VElA组术后住院时间和拔管时间缩短,同时不需要抗凝治疗.
Objectives To compare the effectiveness and complications of 1.9μm-VE1A XL laser vaporization and transurethral resection of the prostate （TURP） in patients with benign prostatic hyperplasia （BPH）.Methods In total,72 consecutive patients with BPH entered the study.All patients underwent general and urological evaluations.The primary outcome was improvement in the International Prostate Symptom Score （IPSS）,IPSS quality of life （QOL）,maximum urinary flow rate （Qmax）,re-sidual volume,and complications were compared in the two groups.All patients were divided randomly into the TURP and laser groups.The laser system emitting at a wavelength of 1.9μm,was used for photoselective vaporization of the prostate （VE1A）.Results Thirty-six patients in each group underwent VE1A and TURP.The mean age was （63.1 ± 9.1） years and （64.7 ± 10.2）years in the VElA and TURP groups,respectively.There were no statistically significant differences in age,prostate size,prostate-specific antigen concentration,Qmax,preoperative IPSS,or preoperative Qmax between the two groups （P ＞ 0.05）.The operation duration was also similar between the groups （P =0.36）.The catheterization time was （1.45 ± 0.75） and （2.63 ± 0.49） days in the VE1A and TURP groups,respectively （P ＜ 0.01）.The VE1A group had a shorter hospital stay than the TURP group.The 3-month postoperative Qmax increased to （9.90 ± 3.61） and （6.59 ± 6.06）mL/s from baseline in the TURP and VE1A groups,respectively,there was no difference in the increases between the groups （P =0.08）.The IPSS and IPSS-QOL were significantly improved with the operation （P ＜ 0.01）,and this improvement was similar in both groups P =0.3 and P =0.8,respectively.The complication rate was also similar between the two groups.Conclusions VE1A with a diode laser is as safe and effective as TURP in the treatment of BPH,and the techniques have similar complication rates and functional results.VE1A has the advantage of shorter hospitalization and cath-eter indwelling times and no need for discontinuation of anticoagulant therapy.
出处
《国际泌尿系统杂志》
2017年第1期81-86,共6页
International Journal of Urology and Nephrology
关键词
前列腺增生
激光
Prostatic Hyperplasia
Laser
