目的: 探讨经尿道电切术(trans urethral resection prostate,TURP)、经尿道前列腺汽化电切术(transurethral resection of the prostate,TUVP)和经尿道选择性钬激光前列腺汽化术(transurethral holmium laser vaporization of the prostate,PVP)三种手术方法治疗前列腺增生症的临床效果。方法: 121例前列腺增生患者随机分为TURP组(40例)、TUVP组(41例)和PVP组(40例)三组,观察三组患者的手术时间、术中出血量、术后膀胱冲洗时间、留置导尿管时间、平均住院时间,并随访3个月观察患者术前术后国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、前列腺大小等指标,进行统计学比较。结果: PVP组与TURP组、TUVP组比较除手术时间较长外,其余术中出血量、冲洗时间、拔管时间和住院时间等指标优于TURP组、TUVP组(P＜0.05);三组患者术后IPSS、Qmax均较术前有提高(P＜0.01),但三组患者术后指标比较,差异无统计学意义(P＞0.05);PVP组患者术后前列腺残余体积大于TURP组和TUVP组患者(P＜0.05);术后并发症总发生率PVP组患者低于TURP组和TUVP组患者(P＜0.05);但TUVP组患者较TURP组患者的并发症发生率低(P＜0.05)。结论: TUVP相对于TURP并发症发生率较低,是一种更加进步的手术方式。而PVP虽然手术时间长,却是3种手术中创伤最小、并发症最少的一种术式,适合高龄高危前列腺增生患者。PVP的缺点是术后复发率较高。

Objective: To study the clinical effects of transurethral resection (TURP), transurethral resection of prostate (TUVP) and selective transurethral holmium laser vaporization prostatectomy (PVP) in the treatment of prostatic hyperplasia.Methods: 121 cases of prostatic hyperplasia patients were divided into TURP group (n=40), TUVP group (n=41) and PVP group (n=40). The operation time, intraoperative blood loss, postoperative bladder irrigation time, indwelling catheter time and hospitalization time were observed and compared in the three groups. IPSS, Qmax, prostate size and other indicators before and after surgery were compared statistically during the 1-3 months' follow-up. Results: The operation time in PVP group was longer, but the amount of bleeding, rinse time, extubation time and hospitalization time were significantly better than those in TURP group and TUVP group (P＜0.05). IPSS and Qmax after operation in the three groups significantly increased (P＜0.01), but there was no statistically significant difference of other postoperative indicators between the three groups (P＞0.05). The postoperative residual prostate gland size in PVP group was significantly higher than that in TURP and TUVP group (P＜0.05). The incidence of postoperative complications in PVP group was lower than that in TURP and TUVP group (P＜0.05); but the complication incidence rate in TUVP group was lower than that in TURP group (P＜0.05).Conclusion: Compared with TURP, TUVP has obvious advantage, with relatively low incidence of complications. Although PVP has a long operation time, it has the smallest incision and the least complications in the three surgical procedures, especially for the elderly and high-risk BPH population. But the disadvantage of PVP is the higher recurrence rate of prostate.