CAJ | 학술논문

目的：比较经尿道2μm激光前列腺剜除术及前列腺电切术治疗大体积良性前列腺增生的疗效及安全性。方法收集2011～2013年间79例在我院手术治疗的前列腺体积＞80 m L患者的临床资料，其中经尿道2μm激光前列腺剜除术45例，前列腺电切术34例，比较两组病例的手术时间、切除的腺体组织重量、术中出血量、持续膀胱冲洗时间、留置尿管时间、手术并发症及手术前后最大尿流率（Qmax）、残余尿量（PVRU）、国际前列腺症状评分（IPSS）、以及生活质量评分（QOL）情况。结果79例患者均一次手术成功，两组患者手术时间、术中出血量、持续膀胱冲洗时间、留置尿管时间比较，差异具有统计学意义（P＜0．05）；两组术中所切除的前列腺体组织重量无统计学差异（P＞0．05）；两组术后发生暂时性尿失禁、泌尿系感染、二次出血的例数比较，差异具有统计学意义（P＜0．05），两组均无死亡病例；两组患者Qmax、PVRU、IPSS及QOL评分较术前均有明显改善（P＜0．05），但两组间比较差异均无统计学意义（P＞0．05）。结论对于前列腺体积＞80 mL的大体积BPH患者，在做好围手术期准备、术者经验丰富的情况下，经尿道2μm激光前列腺剜除术和T U RP均有明显的临床效果，特别是经尿道2μm激光前列腺剜除术更具有术中出血少、安全性高、并发症少等优点。
목적：비교경뇨도2μm격광전렬선완제술급전렬선전절술치료대체적량성전렬선증생적료효급안전성。방법수집2011～2013년간79례재아원수술치료적전렬선체적＞80 m L환자적림상자료，기중경뇨도2μm격광전렬선완제술45례，전렬선전절술34례，비교량조병례적수술시간、절제적선체조직중량、술중출혈량、지속방광충세시간、류치뇨관시간、수술병발증급수술전후최대뇨류솔（Qmax）、잔여뇨량（PVRU）、국제전렬선증상평분（IPSS）、이급생활질량평분（QOL）정황。결과79례환자균일차수술성공，량조환자수술시간、술중출혈량、지속방광충세시간、류치뇨관시간비교，차이구유통계학의의（P＜0．05）；량조술중소절제적전렬선체조직중량무통계학차이（P＞0．05）；량조술후발생잠시성뇨실금、비뇨계감염、이차출혈적례수비교，차이구유통계학의의（P＜0．05），량조균무사망병례；량조환자Qmax、PVRU、IPSS급QOL평분교술전균유명현개선（P＜0．05），단량조간비교차이균무통계학의의（P＞0．05）。결론대우전렬선체적＞80 mL적대체적BPH환자，재주호위수술기준비、술자경험봉부적정황하，경뇨도2μm격광전렬선완제술화T U RP균유명현적림상효과，특별시경뇨도2μm격광전렬선완제술경구유술중출혈소、안전성고、병발증소등우점。
Objective To compare the therapeutic effects of transurethral prostate enucleation with 2 μm laser and tran-surethral resection of prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH) .Methods Clinical data of 79 patients (34 cases treated with TURP ,45 cases treated with 2 μm laser) with severe BPH treated during 2011 and 2013 were analyzed retrospectively .All prostates were larger than 80 mL .Data including operation time ,weight of resected tissues ,intr-aoperative blood loss ,continuous bladder irrigation time ,catheterization time ,complications ,International Prostate Symptom Score (IPSS) ,quality of life (QOL) score ,maximum urinary flow rate (Qmax) ,and postvoid residual urine (PVRU) before and after operation were analyzed .Results All operations were successful .There were significant differences in the opera-tion time ,intraoperative blood loss ,continuous bladder irrigation time and catheterization time between the TURP group and 2μm laser group (P<0 .05) .There was no difference in the weight of resected tissues between the two groups (P>0 .05) .For postoperative complications ,there were significant differences in temporary urinary incontinence ,urinary infection ,and sec-ondary hemorrhage between the two groups (P<0 .05) .There were significant differences in IPSS ,Qmax ,RUV and QOL be-fore operation and 6 months after operation (P<0 .05) .However ,no significant differences were found in these indexes be-tween the two groups (P>0 .05) .Conclusions TURP and 2 μm laser are both effective and safe for patients with severe BPH patients whose prostate volume is larger than 80 mL .With careful management ,2μm laser is a better choice than TURP .