【摘要】 目的比较980nm二极管激光前列腺剜除术(DiLEP)和经尿道前列腺等离子电切术(PKRP)治疗良性前列腺增生的(benign prostatic hyperplasia,BPH)的疗效和安全性。资料和方法回顾性分析复旦大学附属华东医院泌尿外科2014年9月至2016年12月收治的前列腺增生患者的手术病例85例,其中DiLEP手术组43例,PKRP手术组42例。比较两组手术病例术前、术后3个月、6个月和12个月的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)及残余尿量(PVR);比较两组患者的手术时间、手术前后血红蛋白变化、膀胱冲洗时间、留置尿管时间和手术并发症等相关指标。结果两组患者的术前基本资料比较无统计学差异(P>0.05)。DiLEP组的手术时间和膀胱持续冲洗时间短于PKRP组(P<0.001),同时血红蛋白减少量DiLEP组低于PKRP组(P=0.006),但在术后留置导尿时间、住院时间以及切除组织重量方面,两组相比均无统计学差异(P>0.05)。两组患者术后随访结果较术前均改善,但组间比较均无统计学差异。两组患者均无经尿道电切综合征发生(transurethral resection syndrome, TURS)。PKRP组有3例接受输血治疗,而DiLEP组均未输血(P=0.241),但DiLEP组患者术后尿路刺激症状发生率高于PKRP组(P=0.026)。结论 DiLEP治疗前列腺增生患者的手术效果与PKRP相当,在减少术中出血、缩短手术时间方面有明显优势。DiLEP是治疗BPH安全有效的手术方式,可能更加适用于凝血异常的大体积前列腺患者。更多还原

【Abstract】 Objective To compare the curative effect and safety of diode laser enucleation of the prostate(DiLEP) with those of transurethral plasma kinetic resection of the prostate(PKRP) in the treatment of benign prostatic hyperplasia(BPH).Methods A retrospective analysis was made to clinical data of 85 cases with BPH undergoing surgery during the period from Sept.2014 to Dec. 2016, including 43 cases in DiLEP group receiving the second generation 980 nm diode laser enucleation of the prostate and 42 cases in PKRP group receiving transurethral plasma kinetic resection of the prostate; a comparative study was made between the 2 groups in IPSS scores, Omax, PVR before surgery, 3 months, 6 months and 12 months after surgery, the time length of operation, the changes of hemoglobin before and after surgery, the bladder irrigation time, catheterization time and the occurrence of operative complications. Results There existed no statistical difference between the 2 groups in general condition before surgery, catheterization time after surgery, hospitalization duration and the weight of resected tissues(P>0.05);the time length of operation and bladder irrigation time were shorter and the decrease of hemoglobin level was smaller in DiLEP group than those in PKRP group(P<0.001, P=0.006); post-operative follow-up found certain improvement in both groups and the difference between the 2 groups was of no statistical significance; no occurrence of transurethral resection syndrome(TURS)was found in both group; 3 cases in PKRP group received blood transfusion; the occurrence of post-operative irritative symptoms in DiLEP group was higher than that in PKRP group(P=0.026). Conclusions DiLEP is of equivalent effect to PKRP in the treatment of BPH while it is much superior in reducing the bleeding in operation and shortening the time length of operation; DiLEP is effective and safe for BPH, more suitable for cases with large prostates and abnormal coagulation.更多还原