【摘要】：目的:通過160W PVP和80W PVP與TURP治療高危良性前列腺增生癥的對比分析,探討經(jīng)尿道160W綠激光前列腺汽化術(shù)治療高危BPH的安全性及臨床療效。方法:選取2013年9月至2016年3月在我院治療的有一種及以上重要臟器合并癥的老年良性BPH患者180例,隨機分配3組(160W PVP組、80W PVP組、TURP組),每組60例。手術(shù)前后檢測血紅蛋白、血鈉水平;術(shù)后隨訪6個月,檢測術(shù)前及術(shù)后最大尿流率(Qmax)、殘余尿量(PVR),并行國際前列腺癥狀評分(IPSS)、生活質(zhì)量評分(QOL),記錄術(shù)后不良反應(yīng)、留置尿管時間、住院時間及近期并發(fā)癥的發(fā)生情況。結(jié)果:手術(shù)均順利完成,隨訪6個月,無失訪者。三組患者的平均年齡和前列腺的平均體積無統(tǒng)計學(xué)差異(P均0.05)。三組患者術(shù)前、術(shù)后的TPSS、Qmax、PVR、QOL觀察指標比較均有統(tǒng)計學(xué)差異(P均 0.05)。三組的手術(shù)前后血紅蛋白的變化、平均手術(shù)時間比較均有統(tǒng)計學(xué)差異(P均 0.05)。160WPVP組和80W PVP組的術(shù)中血清鈉的變化、術(shù)后留置尿管時間、住院時間的比較無統(tǒng)計學(xué)差異(P0.05),但與TURP組比較均有統(tǒng)計學(xué)差異(P 0.05)。所有患者均未輸血,無前列腺包膜穿孔,無電切綜合征發(fā)生。術(shù)后無尿失禁、繼發(fā)性出血。隨訪期內(nèi)療效滿意。結(jié)論:160W PVP和80W PVP與TURP相比都能有效地減輕前列腺增生癥患者的下尿路癥狀、改善生活質(zhì)量,療效相當(dāng)。同時PVP相對于TURP具有出血少、安全性高的優(yōu)點,尤其新一代高功率160WPVP治療良性前列腺增生癥,術(shù)中出血更少、效率更高、手術(shù)更快,尤其適合合并內(nèi)科疾病、耐受力較差的高危BPH患者。
[Abstract]:Objective: to compare 160W PVP and 80W PVP with TURP in the treatment of high risk benign prostatic hyperplasia (BPH), and to investigate the safety and clinical efficacy of transurethral 160W green laser vaporization of prostate in the treatment of high risk BPH. Methods: from September 2013 to March 2016, 180 elderly patients with benign BPH with one or more important organ complications were randomly assigned to three groups (160W PVP group, 80W PVP group, TURP group) with 60 cases in each group. Hemoglobin and serum sodium levels were measured before and after operation. The patients were followed up for 6 months. The maximum urinary flow rate (Qmax),) residual urine volume (PVR),) and international prostate symptom score (IPSS),) quality of life score (QOL),) were measured before and after operation, and the postoperative adverse reactions and indwelling catheter time were recorded. Length of stay in hospital and occurrence of recent complications. Results: the operations were successfully completed and followed up for 6 months. There was no significant difference in the average age and the mean volume of prostate among the three groups (P 0.05). There were significant differences in TPSS,Qmax,PVR,QOL between the three groups before and after operation. There were significant differences in the changes of hemoglobin and the average operation time between the three groups before and after operation. The changes of serum sodium during operation and the time of indwelling catheter in 160WPVP group and 80W PVP group were significantly different. There was no significant difference in hospitalization time (P 0.05), but there was significant difference with TURP group (P 0.05). No blood transfusion, no prostate capsule perforation and no electroresection syndrome occurred in all patients. There was no urinary incontinence and secondary bleeding after operation. The curative effect was satisfactory during the follow-up period. Conclusion: 160W PVP and 80W PVP can effectively reduce the lower urinary tract symptoms and improve the quality of life in patients with benign prostatic hyperplasia compared with TURP. At the same time, PVP has the advantages of less bleeding and higher safety compared with TURP. Especially, the new generation of high power 160WPVP in the treatment of benign prostatic hyperplasia (BPH) has less intraoperative bleeding, higher efficiency and faster operation, which is especially suitable for medical diseases. High risk BPH patients with poor tolerance.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R699.8

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