经尿道钬激光前列腺剜除术治疗高危高龄前列腺增生患者的安全性及近期疗效研究  

Efficacy and safety of the transurethral holmium laser enucleation of prostate in treatment of elderly benigh prostate hyperplasia with high surgical risk

作　　者：王健 于汝通[1] 张蕊 孙国良[1] 蒋泉[1] Wang Jian;Yu Rutong;Zhang rui;Sun Guoliang;Jiang Quan(Department of Urology,Cheng de Central Hospital,Chengde 067000,China)

机构地区：[1]承德市中心医院泌尿外科,承德067000

出　　处：《微创泌尿外科杂志》2022年第6期402-406,共5页Journal of Minimally Invasive Urology

基　　金：承德市科技计划项目(202006A021)

摘　　要：目的:评估经尿道钬激光前列腺剜除术(HoLEP)治疗高危前列腺增生患者(BPH)的近期疗效及安全性。方法:收集70例高危高龄BPH患者随机分成HoLEP组(n=35)和TURP组(n=35)。对两组患者的围手术期情况、术后3个月的临床疗效以及术后并发症情况进行比较。结果:两组术后3个月的IPSS、RUV、QOL较术前降低,Qmax较术前升高,差异显著(P<0.05)。与TURP组比较,HoLEP组血红蛋白变化小[2.0(2.0,3.0)g/L vs.4.0(2.0,9.0)g/L,P=0.000],手术时间短[(66.14±16.24)min vs.(83.69±23.36)min,P<0.001],留置尿管时间短[(2.49±0.62)dvs.(5.31±0.80)d,P=0.000],切除腺体多[(44.09±15.83)g vs.(35.77±10.13)g,P=0.011],术后住院时间短[(4.68±1.04)dvs.(6.77±1.54)d,P<0.000]。HoLEP术后并发症例数低于TURP组(P<0.05)。结论:在治疗高危高龄BPH方面,两种手术方式近期疗效相当,但HoLEP恢复更快,更安全,是高危高龄BPH的更好的选择。Objective:To investigate the primary effect and safety of transurethral holmium laser enucleation of prostate(HoLEP)in treatment of high surgical risk benign prostatic hyperplasia(BPH).Methods:A total of 70 elderly and high surgical risk BPH were randomly assigned into HoLEP group(n=35)and transurethral resection of the prostate(TURP)group(n=35).The clinical data of all the patients were collected and compared between the HoLEP and TURP group,including the pre-operation characteristic and three month after operation characteristic and complications after operation.Results:Compared with the data before the surgery,IPSS score,RUV,and QOL score of the two groups were greatly decreased and Qmax increased at 3 months after the operation(P<0.05).However,HoLEP takes the advantages of less hemoglobin changes[2.0(2.0,3.0)g/L vs.4.0(2.0,9.0)g/L,P=0.000],shorter operation time[(66.14±16.24)min vs.(83.69±23.36)min,P<0.001],less catheterization time[(2.49±0.62)d vs.(5.31±0.80)d,P=0.000],more tissue removed[(44.09±15.83)g vs.(35.77±10.13)g,P=0.011]and shorter hospital stay after the surgry[(4.68±1.04)d vs.(6.77±1.54)d,P<0.000].The HoLEP group had fewer complications than that in the TURP group(P<0.05).Conclusion:Both HoLEP and TURP have same therapeutic effect in treatment of elderly BPH with high surgical risk.But HoLEP surgery takes the advantages of quicker postoperative recovery and safer than TURP.

关 键 词：前列腺增生 前列腺切除除术 

分 类 号：R699.8[医药卫生—泌尿科学]