【摘要】 目的 探讨应用180 W XPS绿激光系统行经尿道前列腺汽化切除术(VIT)和行经尿道前列腺选择性汽化术(PVP)治疗复发性高危前列腺增生(BPH)的临床疗效和安全性。方法 回顾性分析2019年6月至2021年7月在苏州大学附属第二医院接受180 W XPS绿激光系统治疗的104例复发性高危BPH患者的资料,其中VIT 54例、PVP 50例。对两组的国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、膀胱残余尿量(PVR)、前列腺体积、PSA,以及围术期指标和并发症发生情况等进行比较分析。结果 所有患者均顺利完成手术,VIT组和PVP组的手术时间[(58.3±13.6)min vs (69.1±16.1)min]比较差异有统计学意义(P<0.05);VIT组和PVP组的术后血红蛋白下降值、留置导尿管时间和住院时间分别为[(9.4±4.3)g/L和(9.0±4.2)g/L、[3.0(2.8,3.0) d和3.0(2.0,3.0) d]、[4.0(4.0,4.0) d和4.0(4.0,4.0) d],两组差异比较无统计学意义(P>0.05);术后第3、6、12个月时VIT组的IPSS评分及PSA均低于PVP组,差异有统计学意义(P <0.05),而VIT组的Qmax均高于PVP组,差异有统计学意义(P <0.05);VIT组和PVP组术后尿路刺激症发生情况[3(5.5%) vs 10(20.0%)]比较差异有统计学意义(P<0.05)。结论 使用180 W XPS绿激光系统行VIT治疗复发性高危BPH具有手术时间短、失血量少、PSA值下降明显和并发症少等优点,是安全有效的手术方式。更多还原

【Abstract】 Objective To explore the clinical efficacy and safety of vaporization-incision technique(VIT) with 180 W XPS green laser treatment system in the treatment of recurrent high-risk benign prostatic hyperplasia(BPH). Methods A retrospective analysis of 104 patients with highrisk recurrent BPH who used 180 W XPS green laser system in the treatment from June 2019 to July 2021 in Second Affiliated Hospital of Soochow University was performed.Among them, 54 patients were treated with VIT, and 50 patients were treated with photoselective vaporization of the prostate(PVP). The IPSS, QOL, Qmax, PVR, PV, PSA, perioperative indicators and complications were compared and analyzed. Results All 104 patients with high-risk recurrent BPH were successfully performed.The average operation time was [(58.3±13.6)min vs(69.1±16.1)min](P<0.05). There was no significant difference in the amount of postoperative hemoglobin decline [(9.4±4.3)g/L vs(9.0±4.2)g/L], catheterization time [3.0(2.8,3.0)d vs 3.0(2.0,3.0)d] or the postoperative hospitalization time [4.0(4.0,4.0)d vs 4.0(4.0,4.0)d] between the two groups(all P>0.05).At the followup of 3, 6 and 12 months after operation, IPSS and PSA in the VIT group were lower than those in the PVP group, and the differences were all statistically significant(all P<0.05).Peak urinary flow rate in the VIT group was higher than that in the PVP group, with statistically significant differences(P<0.05). There were 3 cases(5.5%) of urinary tract irritation in the VIT group and 10 cases(20.0%) in the PVP group(P<0.05). Conclusions Using 180 W green laser VIT is safe and effective method for the treatment of patients with recurrent high-risk BPH because of short operation time, less intraoperative bleeding, significant PSA decrease and fewer complications.更多还原