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经尿道绿激光前列腺汽化术治疗良性前列腺增生的有效性和安全性的临床研究
Clinical Research of the Efficacy and Safety of Transurethral Greenlight Laser Vaporization of the Prostate for Benign Prostatic Hyperplasia
【作者】 王国民；
【导师】 何乐业；
【作者基本信息】 中南大学 ， 外科学， 2011， 硕士
【摘要】 目的：通过与经尿道前列腺等离子电切术(PKRP)的对比研究,评估绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)的有效性和安全性。方法：2009年12月至2010年9月我院收治的70例BPH患者纳入本研究。随机单盲的方法分为两组,其中PVP组35例(实验组),PKRP组35例(对照组),出院后3个月返院由专人负责复查。使用病例报告表记录术前、出院时和出院后3个月的临床观察指标,包括国际前列腺症状评分(IPSS)、生活质量指数(QOL)、男性性功能四项(MSF-4)、手术时间、术中失血、冲洗液量、电解质等,以及并发症。采用SPSS13.0统计软件对上述资料进行统计学分析和评估。结果：70例患者中11例失访脱落,其中PVP组脱落5例,PKRP组脱落6例。两组患者的术前指标无明显统计学差异,两组间的手术时间、术中冲洗液量、实验室检查、住院时间、导尿管拔除时间、膀胱冲洗时间无明显差异(P>0.05), PVP组的失血量要显著低于PKRP组(P<0.05)。手术后两组患者IPSS、QOL、Qmax、Qave均得到显著的改善。PVP组和PKRP组分别有2例(7.0%)和3例(10.0%)发生尿道狭窄(P>0.05)。两组患者术后性功能与术前相比均无显著差异。结论：PVP是一种治疗BPH的安全有效的方法,其出血量明显少于PKRP,而其短期(三个月内)疗效及安全性与PKRP类似,长期疗效有待随后进一步评估。
【Abstract】 Objective:To evaluate the efficacy and safety of greenlight laser vaporization of the prostate (PVP) by comparing with transurethral plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia.Methods:Among the patients with BPH treated in our hospital from Dec. 2009 to Sep.2010,70 cases were included in our study. A randomized, single blind trail was performed to divide all cases into two groups. Thirty-five patients were assigned into PVP group (experimental group), and the other thirty-five patients were in PKRP group (control group). All the patients returned to our hospital and underwent reexamination which is administered by especially appointed staff at the third month after hospital discharge. We documented the clinical data of pre-operation, hospital discharge and 3 months later by means of the case report form with items of international prostate symptom score (IPSS), quality of life (QOL), male sexual function 4-item (MSF-4), operation time, loss of blood, irrigation volume, electrolyte and complications etc. All statistical analyses and assessment were performed with SPSS software (version 13.0).Results:A total of 11 patients were lost to follow up,5 cases in PVP group and 6 cases in PKRP group, respectively. There was no significant difference between the two groups in the data of preoperative situations, operation time, irrigation volume, lab tests, hospital stays, catheterization time and irrigation time (P>0.05). The loss of blood of the PVP group was less than that of the PKRP group (P<0.05). IPSS, QOL, Qmax,Qave in both groups were remarkably improved. There were 2 cases of anterior urethral strictures (7.0%) in PVP group and 3 cases (10.0%) in PKRP group respectively (P>0.05). There were no changes of sexual function before and after surgeries of all patients.Conclusion:PVP is a safe and efficient operative procedure for BPH, prior to PKRP for less loss of blood in the process of sugery while smilar in short-term (within three months) safety and efficacy.The long-term validity is necessary to be evaluated forward.