目的 总结分析直出绿激光前列腺汽化切除术(PVRP)与选择性绿激光前列腺汽化术(PVP)在治疗良性前列腺增生症(BPH)方面的安全性和临床疗效.方法 将113例BPH患者随机分为两组,PVRP组62例,PVP组51例.比较两组手术时间、术中出血量、术后持续膀胱冲洗时间、导尿管留置时间;观察两组手术前、后生活质量评分(QOL)、国际前列腺症状评分(IPSS)、残余尿量(PVR)、最大尿流率(Qmax)及术后并发症发生情况.结果 所有患者手术均成功,无严重并发症发生.PVRP手术时间(49.4±18.9)min明显少于PVP组(75.1±20.7)min(P<0.05);两组间术中出血量、膀胱冲洗时间比较差异无统计学意义(P>0.05).两组术后6个月Qmax、PVR、IPSS、QOL均明显改善,与术前比较差异均有统计学意义(P<0.05).两组间比较,上述指标间差异均无统计学意义(P>0.05).结论 直出光PVRP及PVP治疗BPH安全、有效,PVRP在手术时间上较PVP更有优势.%Objective To discuss the safety and efficacy of straight light beam greenlight photoselective vaporesection of the prostate (PVRP) and photoselective vaporization of the prostate (PVP) in treatment of benign prostatic hyperplasia. Methods 113 cases of BPH were randomly divided into two groups, 62 cases in PVRP group and 51cases in PVP group. Clinical data was collected and compared between the two groups, including pre-operation and six month after operation international prostate symptom score (IPSS), quality of life (QOL), urine flow rate (Qmax), postvoid residual urine (PVR), as well as operational time, operative bleeding volume, bladder irrigation time, indwelling catheter time after operation and complications after operation. Results All the patients were operated successfully without serious complications. There was significant difference in operative time [(49.4 ± 18.9) min vs (75.1 ± 20.7) min (P < 0.05)] between the two groups. There were no significant difference in blood loss and bladder washing time after operation. The Qmax after 6 months of surgery, PVR, IPSS, QOL of the two groups had significantly improved compared with preoperative (P < 0.05), while the difference between the two groups had no significance in statistics (P > 0.05). Conclusions Treatment of straight light beam greenlight PVRP and PVP are safe and effective for BPH. Straight light beam greenlight PVRP has the advantages of shorter operation time.
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