比较经尿道直出绿激光推铲式汽化切剜术（LS-VREP）与经尿道前列腺电切术（TURP）治疗前列腺增生（BPH）的临床疗效，以及其对患者免疫功能的影响。

2017年1月至2019年3月对我院86例BPH患者进行回顾性研究，LS-VREP组43例，TURP组43例，比较两组的手术时间、术中出血量、术后膀胱冲洗时间、术后留置尿管时间、住院时间、并发症发生率；检测手术前后血液的免疫指标（IgG、IgA、lgM、CD8⁺CD28^-、CD8⁺CD28⁺）；并比较术前、术后3个月、术后6个月的国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）及残余尿量（RUV）。

86例患者均顺利完成手术，LS-VREP组手术时间、术中出血量、术后膀胱冲洗时间、术后留置尿管时间、术后住院时间、并发症发生率依次为（47.4±18.3）min、（62.9±33.4）ml、（18.3±5.1）h、（32.5±10.6）h、（4.3±1.6）d、4.8%，TURP组分别为（49.6±21.1）min、（106.5±57.2）ml、（45.7±10.9）h、（53.8±13.4）h、（5.9±2.4）d、12.8%；LS-VREP组在减少出血量及并发症，缩短术后留置尿管时间、膀胱冲洗时间及住院时间方面明显优于TURP组（P<0.05）。LS-VREP组术后CD8⁺CD28^-明显低于TURP组（P<0.05)，而IgG、IgA、CD8⁺CD28⁺高于TURP组，但两组术后lgM、CD8⁺水平差异无统计学意义（P>0.05）。随访6～18个月，平均11个月，4例失访，随访患者无远期并发症。

与TURP相比，LS-VREP具有安全可控，手术时间短，术中出血少，术后并发症少，恢复快等优点，更有利于保护机体免疫功能，值得推广应用。

To compare the clinical effect of transurethral laser shovel type vapor-resection-enucleation of the prostate (LS-VREP) and transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH), and to evaluate immune function of LS-VREP in treatment of BPH.

A retrospective analysis of 86 patients with BPH from January 2017 to March 2019 in our hospital were included, they were divided into two groups, 43 cases were treated with LS-VREP, other 43 cases were treated with TURP. Comparisons between the two groups were made with respect to duration of operative time, intraoperative blood loss, postoperative irrigation time, postoperative indwelling catheterization, hospital stay and complication rate. Moreover, blood indicators changes of immune function (IgG, IgA, lgM, CD8⁺CD28^-, CD8⁺CD28⁺) in patients with BPH before surgery and after surgery, indicators changes of IPSS, QOL, Qmax and RUV in the preoperative, postoperative 3 months and postoperative 6months between two groups were detected.

All the 86 patients underwent sugery successfully. The mean operative time, blood loss, postoperative irrigation time, indwelling catheterization, postoperative hospital stay and complication rate were (47.4±18.3) min, (62.9±33.4) ml, (18.3±5.1) hours, (32.5±10.6) hours, (4.3±1.6) days, 4.8% in group LS-VREP and (49.6±21.1) min, (106.5±57.2) ml, (45.7±10.9) hours, (53.8±13.4) hours, (5.9±2.4) days, 12.8% in group TURP. Besides, LS-VREP reduce blood loss and complications, shorten postoperative irrigation time, indwelling catheterization and hospital stay(P<0.05). After surgery, the levels of CD8⁺CD28^- in group LS-VREP were significantly lower than in group TURP (P<0.05), and the levels of IgG, IgA, CD8⁺CD28⁺ in group LS-VREP were significantly higher than in control group (P<0.05). But there were no significant difference between the two groups in levels of lgM and CD8⁺ (P>0.05). Average postoperative follow-up was 11 months (range 6-18) in 82 patients, and no patient had long term complication.

In comparison with TURP, LS-VREP demonstrates safety and controllable, shorter operative time, less blood loss, less complications, faster postoperative recovery, better protects immune function. Thus, it is worthily recommended in the clinical application.