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[绿激光前列腺选择性汽化术与等离子前列腺切除术治疗高龄高危良性前列腺增生症患者的疗效评估:一项前瞻性随机对照试验]

[Evaluation of greenlight photoselective vaporization of prostate and plasmakinetic resection of prostate for the treatment of eldly benign prostatic hyperplasia men with high surgical risk: a prospective randomised control trial].

作者信息

Liu Ling, Lei Jun-Hao, He Qi-Ying, Li Xiang, Yang Lu

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2014 Jul;45(4):708-11.

Abstract

OBJECTIVE

To compare the clinical effects and safety between greenlight photoselective vaporization of prostate (PVP) and plasmakinetic resection of prostate (PRP) in eldly benign prostatic hyperplasia (BPH) men with high surgical risk. METHODS; Fifty three eldly BPH patients, who had the indication of surgical treatment but complicated with at least one internal disease, were randomly divided into PVP group and PRP group. The clinical data of all the patients were collected and compared between the two groups, including pre-operative and post-operative international prostate symptom score (IPSS), postvoid residual urine (PVR), urine flow rate (Qmax), quality of life (QOL) as well as prostate volume (PV), operational time, operative bleeding volume, postoperative recovery, peri-operative complications.

RESULTS

The complete follow-up data of 44 patients were achieved: 21 of PVP, 23 of PRP. There were significant differences between two groups in operative bleeding, bladder irrigation time, indwelling catheter time and hospital stay (P < 0.002). The peri-operative bleeding was lower in PVP group, while the bladder irrigation time, indwelling catheter time and hospital stay were shorter in PVP group. The operation time showed no difference (P = 0.12). No significant differences were found 3 months postoperatively between two groups in all the data associated with urination (IPSS, Qmax, PVR, QOL), P > 0.05. Complications (urethrostenosis, retrograde ejaculationwere acceptable in both groups.

CONCLUSION

For surgical treatment of eldly men with high surgical risk, both PVP and PRP are safe and effective with the internal disease being sufficient control.

摘要

目的

比较绿激光选择性前列腺汽化术(PVP)与等离子前列腺切除术(PRP)治疗具有高手术风险的老年良性前列腺增生(BPH)患者的临床疗效及安全性。方法:53例有手术治疗指征但合并至少一种内科疾病的老年BPH患者,随机分为PVP组和PRP组。收集两组患者的临床资料并进行比较,包括术前及术后国际前列腺症状评分(IPSS)、残余尿量(PVR)、最大尿流率(Qmax)、生活质量(QOL)以及前列腺体积(PV)、手术时间、术中出血量、术后恢复情况、围手术期并发症。

结果

44例患者获得完整随访资料:PVP组21例,PRP组23例。两组在术中出血、膀胱冲洗时间、留置导尿管时间及住院时间方面差异有统计学意义(P<0.002)。PVP组围手术期出血量较少,膀胱冲洗时间、留置导尿管时间及住院时间较短。手术时间差异无统计学意义(P=0.12)。术后3个月两组排尿相关各项数据(IPSS、Qmax、PVR、QOL)差异无统计学意义(P>0.05)。两组并发症(尿道狭窄、逆行射精)均可接受。

结论

对于具有高手术风险的老年男性患者,在充分控制内科疾病的情况下,PVP和PRP均安全有效。

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