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经尿道前列腺绿激光剜除术与经尿道前列腺汽化术对重度良性前列腺增生的治疗效果比较

Transurethral green laser enucleation of prostate versus transurethral vaporization of prostate in treatment of severe benign prostatic hyperplasia

    摘要
  • 摘要:
    目的 比较经尿道前列腺绿激光剜除术(GLEP)与经尿道前列腺汽化术(TUVP)对重度良性前列腺增生(BPH)的治疗效果。
    方法 选取重度BPH患者214例作为研究对象, 随机分为GLEP组与TUVP组，每组107例。比较2组患者围术期指标和手术前后最大尿流率(Qmax)、残余尿量(RUV)、血清总前列腺特异性抗原(tPSA)水平、国际前列腺症状评分量表(IPSS)评分、BPH患者生活质量(BPH-QOL)评分、国际勃起功能问卷-5(ILEF-5)评分。
    结果 GLEP组术中出血量、手术时间、术后膀胱冲洗时间、导尿管留置时间和住院时间分别为(56.85±10.21) mL、(75.83±9.12) min、(25.12±5.03) h、(1.91±0.62) d和(3.52±0.83) d, 少于或短于TUVP组的(60.43±11.05) mL、(91.49±12.95) min、(40.21±9.78) h、(2.76±0.74) d和(4.45±1.17) d, 差异有统计学意义(P < 0.05)。术后6个月, 2组Qmax、BPH-QOL评分均高于术前, RUV、血清tPSA水平、ILEF-5评分、IPSS评分均低于术前，差异有统计学意义(P < 0.05);术后6个月, GLEP组Qmax为(23.35±4.41) mL/s, 高于TUVP组的(20.03±3.95) mL/s, GLEP组ILEF-5评分为(10.29±2.85)分, 高于TUVP组的(8.38±2.16)分，差异有统计学意义(P < 0.05)。GLEP组总并发症发生率为5.61%, 低于TUVP组的22.43%, 差异有统计学意义(P < 0.05)。
    结论 GLEP与TUVP治疗重度BPH的近期疗效相当，但GLEP术中出血量更少，术后康复更快，且并发症更少，对性功能的影响更轻。

     

    Abstract:
    Objective To compare the efficacy of transurethral green laser enucleation of the prostate (GLEP) and transurethral vaporization of prostate (TUVP) in the treatment of patients with severe benign prostatic hyperplasia (BPH).
    Methods A total of 214 patients with severe BPH were selected and randomly divided into GLEP group and TUVP group, with 107 cases in each group. The perioperative indexes as well as the maximum urinary flow rate (Qmax), residual urine volume (RUV), serum total prostate specific antigen (tPSA), score of the International Prostate Symptom Scale (IPSS), the score of Quality of Life for BPH patients (BPH-QOL) and score of the International Erectile Function Questionnaire-5 (ILEF-5) before and after the surgery were compared between two groups.
    Results The intraoperative bleeding amount, operation time, postoperative flushing time for bladder, indwelling time of the catheter and hospital stay in the GLEP group were (56.85±10.21) mL, (75.83±9.12) min, (25.12±5.03) h, (1.91±0.62)d and (3.52±0.83) d, respectively, which were significantly less or shorter than (60.43±11.05) mL, (91.49±12.95) min, (40.21±9.78) h, (2.76±0.74)d and (4.45±1.17)d in the TUVP group (P < 0.05). At 6 months after operation, Qmax and BPH-QOL score in both groups were significantly higher than those before operation, while RUV, serum tPSA level, ILEF-5 score and IPSS score were significantly lower than those before operation (P < 0.05); at 6 months after operation, Qmax was (23.35±4.41) mL/s in the GLEP group, which was significantly higher than (20.03±3.95) mL/s in the TUVP group, and ILEF-5 score was (10.29±2.85) in the GLEP group, which was significantly higher than (8.38±2.16) in the TUVP group (P < 0.05). The total incidence rate of complications in the GLEP group was 5.61%, which was significantly lower than 22.43% in the TUVP group (P < 0.05).
    Conclusion GLEP and TUVP have the similar short-term efficacy in the treatment of patients with severe BPH, but GLEP has less intraoperative bleeding amount, faster postoperative recovery, fewer complications and less influence on sexual function.

     

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