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目的探讨经尿道绿激光汽化术(PVP)与经尿道前列腺电切术(TURP)治疗高危前列腺增生症疗效和安全性。方法老年高危前列腺增生症患者160例,随机分为两组,PVP组(80例)和TURP组(80例)。观察两组患者的手术时间、术后住院时间、尿管留置时间、围手术期及术后并发症发生率,术后1个月、12个月的国际前列腺症状评分(IPSS)、生活质量评分(quality of life,QOL)、最大尿流率(maximum urinary flow rate,Qmax)、残余尿量(residual urine volume,RUV)。结果两组患者均取得了较理想的临床疗效,症状缓解明显。与TURP组患者比较,PVP组患者手术时间[(49.5±17.3)分钟]、住院时间[(4.1±1.3)天]和尿管留置时间[(2.2±1.0)天]明显较短,差异有统计学意义(P<0.05)。与术前比较,PVP组和TURP患者术后的IPSS评分、QOL评分、Qmax、RUV较术前明显改善。TURP组围手术期的并发症发生率明显高于PVP组(P<0.05)。结论PVP是治疗BPH的一种安全、有效的微创手术方法,尤其适用于高危老龄患者。
Objective To investigate the efficacy and safety of transurethral vaporization of the liver (PVP) and transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). Methods 160 elderly patients with benign prostatic hyperplasia were randomly divided into two groups: PVP group (80 cases) and TURP group (80 cases). The operation time, postoperative hospital stay, catheter indwelling time, the incidence of perioperative and postoperative complications, the International Prostate Symptom Score (IPSS) at 1 month and 12 months postoperatively, the quality of life score quality of life (QOL), maximum urinary flow rate (Qmax), residual urine volume (RUV). Results The two groups of patients have achieved better clinical efficacy, symptoms were significantly relieved. Compared with TURP group, the operation time [(49.5 ± 17.3) min], hospital stay [(4.1 ± 1.3) days) and catheter indwelling time [(2.2 ± 1.0) days] in PVP group were significantly shorter with statistical difference Significance (P <0.05). Compared with preoperative, the IPSS score, QOL score, Qmax and RUV in PVP group and TURP group were significantly improved compared with those before operation. The incidence of perioperative complications in TURP group was significantly higher than that in PVP group (P <0.05). Conclusion PVP is a safe and effective minimally invasive surgical method for the treatment of BPH, especially for high-risk and elderly patients.