摘要
目的:比较绿激光汽化切除术(PVP)与经尿道双极等离子电切术(TUPKRP)治疗良性前列腺增生(BPH)的安全性和有效性。方法:通过检索Pubmed、Cochrane library、CBM、EMBASE、Medline、CNKI、万方、维普等数据库,筛选符合要求的PVP和TUPKRP对照研究,并对文献进行质量评价和资料提取,最后应用统计软件Rev Man5.3完成Meta分析。结果:最终纳入7篇文献,总样本量为619例。Meta分析结果显示:1安全性方面:PVP组患者比TUPKRP组患者术中出血量少[WMD=92.85,95%CI(56.09,129.60)(P<0.01)],膀胱冲洗时间短[WMD=0.47,95%CI(0.23,0.72)(P=0.0002)],术后留置尿管时间短[SMD=3.44,95%CI(1.73,5.15)(P<0.01)],住院时间短[WMD=1.76,95%CI(0.93,2.59)]。但PVP组患者比TUPKRP组患者手术时间长[WMD=-14.04,95%CI(-20.51,-7.58)(P<0.01)],差异有统计学意义。术后膀胱痉挛情况及术后3个月尿路狭窄情况二者差异无统计学意义(P>0.05)。2有效性方面:术后3个月随访,两组患者IPSS评分、QOL评分、Qmax差异均无统计学意义(P>0.05)。结论:PVP与TUPKRP在改善患者的IPSS评分、QOL评分和Qmax等膀胱出口梗阻指标方面有相似的临床疗效,然而PVP术中出血少,膀胱冲洗时间、留置尿管时间、住院时间短,更安全,更具优势。
Objective： To compare the clinical effects and safety between transurethral bipolar plasmakinetic resection of prostate （TUPKRP） and photoselective vaporization （PVP） with green laser in treating BPH. Method： Databases such as Pubmed, Cochrane library, CBM, Embase, Mediine, CNKI, wanfang and Weipu were searched from their establishment to collect the randomized controlled trials （RCTs） and non-RCTs about PVP vs TUPKRP for the treatment of BPH. After the study selection, assessment and data extraction were conducted by two reviewers independently, and meta analyses were performed using the Rev-Man 5.3 software. Result.. Seven studies involving 619 patients were included. The results of meta analyses showed that= （1） safety indicator compared with TUPKRP, less blood loss [WMD=92.85, 95%CI （56.09, 129.60） （ P 〈0.01）], shorter bladder irrigation time [WMD=0.47, 95%CI （0.23, 0.72） （P =0.0002）1, shorter catheterization time [SMD=3.44, 95%CI （1.73, 5.15） （ P〈0.01）] and shorter hospital stay [WMD= 1.76, 95%CI （0.93, 2.59）] were found in PVP, but patients with PVP experienced longer operation time [WMD= -14. 04 , 95%CI （--20.51, --7.58） （ P 〈0. 01）]. However, there was no significant difference in urethral stricture and bladder spasm （ P〈0.05）. @ efficacy indicator.. IPSS, QOL, Q after three months had no significant difference between the two groups （ P 〈0.05）. Conclusion： PVP shows similar effects on significant improvements in IPSS, QOL and Q to TUP- KRP. However, PVP is superior to TUPKRP in intraoperative blood loss, time of indwelling catheter, time of bladder irrigation and hospital stay after operation.
出处
《临床泌尿外科杂志》
2015年第9期776-782,785,共8页
Journal of Clinical Urology
关键词
绿激光汽化切除术
经尿道前列腺双极等离子电切术
良性前列腺增生
META分析
photoselective vaporization with green laser
transurethral bipolar plasmakinetic resection ofprostate
benign prostatic hyperplasia
meta analysis
