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目的对比经尿道前列腺汽化电切术(Transurethral Vaporization Resection of the Prostate, TUVRP)、经尿道前列腺等离子体双极电切术(Bipolar Plasmakinetic Transurethral Resection of Prostate, PKRP)以及经直肠高强度聚焦超声(Transrectal High-intensity Focused Ultrasound, HIFU)前列腺消融术治疗前列腺增生症(benign prostatic hyperplasia,BPH)的临床疗效.方法将471例前列腺增生患者按术式不同分为三组,其中TUVRP组102例,PKRP组225例,HIFI组144例,回顾分析并比较各组术后一般情况及并发症等,并对相关指标进行统计学分析.结果3组病人术前一般情况比较无统计学差异(P>0.05).HIFU组的术后相关指标及并发症与TUVRP组和PKRP组差异有显著性(P<0.05),HIFU组的手术时间、持续膀胱冲洗时间、术后留置尿管时间、住院时间均短于TUVRP组和PKRP组,且术中出血量、术中输血量以及并发症均明显低于TUVRP组和PKRP组.TUVRP组和PKRP组在手术时间、持续膀胱冲洗时间、TUR综合征发生率的差异有统计学意义(P0.05).各组术后主、客观症状均较术前明显改善,差异有统计学意义(P<0.05).而HIFU组术后3个月时与术后2年时的主、客观指标比较,发现两者有显著性差异(P0.05). HIFI group was different from TUVRP and PKRP group in post-operative complication and related indicator. (P<0.05). The operative time, continuous bladder irrigating time, time of indwelling urinary catheter, hospital stay, amount of bleeding, amount of blood transfusion, the occurrence of complications were shorter than those in TUVRP and PKRP group.There were significant differences between TUVRP and PKRP group in operative time, continuous bladder irrigating time, incidence of TURS. (P0.05) Qmax, RUV, PV, IPSS, QOL were significantly improved in each group after the procedure(P<0.05). The subjective and objective symptoms further improved after 2 years in HIFI group,but was still lower than that of TUVRP and PKRP group. Conclusion All three methods are effective for treatment of BPH. TUVRP was similar to PKRP in efficacy,but the security of PKRP was higher than that of TUVRP. Generaly,security of transrectal high intensity focused ultrasound for treatment of BPH was better than that of TUVRP and PKRP group.