【摘要】：目的:對比分析經(jīng)尿道半導(dǎo)體激光前列腺剜除術(shù)(DIOD)與前列腺電切術(shù)(TURP)治療不同體積良性前列腺增生(BPH)的臨床療效。方法:回顧性分析2012年3月至2015年8月本院收治的256例BPH患者,其中141例采用DIOD,115例采用TURP。術(shù)前按前列腺體積大小分為3組,60 ml組中42例行DIOD術(shù),31例行TURP術(shù);60~80 ml組中51例行DIOD術(shù),45例行TURP術(shù);80 ml組中48例行DIOD術(shù),39例行TURP術(shù);對比分析3組患者兩種治療方法的臨床療效,各組圍手術(shù)期平均手術(shù)時(shí)間、血紅蛋白變化率、Na+變化率、膀胱沖洗時(shí)間、留置尿管時(shí)間,以及術(shù)前術(shù)后血清PSA、IPSS評分、最大尿流率(Qmax)、殘余尿(PVR)等指標(biāo)變化。結(jié)果:60 ml組圍手術(shù)期各項(xiàng)指標(biāo)及術(shù)后隨訪指標(biāo)在兩種手術(shù)方法間無明顯差異;60~80 ml組中DIOD組血紅蛋白變化[(3.25±1.53)g/L]、Na+變化[(3.58±1.27)mmol/L]、沖洗時(shí)間[(30.06±6.22)h]、留置尿管時(shí)間[(47.61±13.55)h]明顯優(yōu)于TURP組[(4.77±1.67)g/L、(9.67±2.67)mmol/L、(58.32±10.25)h、(68.01±9.69)h](P0.05),DIOD組術(shù)后PSA下降大于TURP組[(2.34±1.29)μg/L vs(1.09±0.72)μg/L,P0.05];80 ml組中DIOD組術(shù)后PSA下降大于TURP組[(3.35±1.39)μg/L vs(1.76±0.91)μg/L,P0.05)],且圍手術(shù)期各項(xiàng)指標(biāo)明顯優(yōu)于TURP組(P0.05或P0.01)。DIOD組無輸血、經(jīng)尿道電切綜合征、尿道狹窄等并發(fā)癥發(fā)生,但假性尿失禁發(fā)生率高于TURP組(22.70%vs 7.83%)(P0.01)。結(jié)論:DIOD治療BPH短期療效確切,具有出血少、恢復(fù)快、安全性高的特點(diǎn)。在中、大體積前列腺中優(yōu)勢明顯,而對小體積前列腺與TURP療效相當(dāng)。
[Abstract]:Objective: to compare the clinical effects of transurethral semiconductor laser enucleation of the prostate (DIOD) and electroprostatectomy (TURP) in the treatment of benign prostatic hyperplasia (BPH) with different volumes. Methods: a retrospective analysis of 256 patients with BPH admitted from March 2012 to August 2015 in our hospital was made, of which 141 cases were treated with DIOD,115 and TURP. was used. According to the volume of prostate, 42 cases were divided into 3 groups according to the volume of prostate, 42 cases were treated with DIOD, 31 cases were treated with TURP, 31 cases were treated with TURP, 51 cases were treated with DIOD, 45 cases were treated with TURP, 48 cases were treated with DIOD and 39 cases with TURP. The mean operative time, the change rate of hemoglobin and Na, the time of bladder irrigation, the time of indwelling urinary catheter, the preoperative and postoperative serum PSA,IPSS score, the maximum urinary flow rate (Qmax),) residual urine (PVR) and so on were all changed in each group. 緇撴灉:60 ml緇勫洿鎵嬫湳鏈熷悇欏規(guī)寚鏍囧強(qiáng)鏈悗闅忚鎸囨爣鍦ㄤ袱縐嶆墜鏈柟娉曢棿鏃犳槑鏄懼樊寮，

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