经尿道钬激光前列腺剜除治疗大体积前列腺增生的研究  

Study o transurethral holmium laser enucleation of the prostate in treatment of large-volume benign prostatic hyperplasia

作　　者：张菊根[1] 

机构地区：[1]上海市中山医院青浦分院,上海201700

出　　处：《现代中西医结合杂志》2015年第33期3658-3661,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察经尿道钬激光前列腺剜除术(Ho LEP)和经尿道前列腺汽化电切术(TUEVP)治疗大体积良性前列腺增生症(BPH)的疗效及对血清前列腺特异性抗原(PSA)、胰岛素生长因子-1(IGF-1)和胰岛素生长因子结合蛋白-3(IGFBP-3)水平的影响。方法根据手术方式不同将133例大体积BPH患者分为2组,观察组85例行Ho LEP治疗,对照组48例行TUEVP治疗。观察2组出血量、手术时间、切除质量、膀胱冲洗时间、留置尿管时间、住院时间、并发症发生情况,治疗前后最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量指数(QOL)、残余尿量(RUV)及血清PSA、IGF-1、IGFBP-3水平。结果观察组的出血量、手术时间、切除质量、膀胱冲洗时间、留置尿管时间和住院时间均明显少于或者短于对照组(P均<0.05),2组并发症发生率比较差异无统计学意义(P>0.05)。2组治疗后IPSS、QOL、RUV及血清PSA、IGF-1、IGFBP-3水平均较治疗前明显降低(P均<0.05),Qmax较治疗前明显升高(P均<0.05),且观察组血清PSA、IGF-1和IGFBP-3水平较对照组降低更为明显(P均<0.05),2组IPSS、QOL、RUV比较差异均无统计学意义(P均>0.05)。结论 Ho LEP治疗BPH疗效显著,能够明显提高患者术后生活质量,具有术中出血少、手术时间短、创伤小的优点,且可降低血清PSA、IGF-1和IGFBP-3水平。Objective It is to observe the curative effect of transurethral holmium laser enucleation of the prostate （ Ho- LEP） and transurethral electro-vaporization resection of the prostate （TUEVP） in treatment of large-volume benign prostatic hyperplasia （BPH） and their impact on the levels of prostate specific antigen （PSA） , insulin growth factor - 1 （ IGF - 1 ） and insulin-like growth factor binding protein - 3 （ IGFBP - 3 ）. Methods 233 patients with large-volume BPH were divided into observation group （85 cases） and control group （48 cases） according to the surgical procedure, the patients were treated with HoLEP in the observation group and TUEVP in the control group. The blood loss, surgical time, excision quality, bladder irri- gation time, indwelling catheter time, hospital stay and incidence of complication were observed in two groups, and the levels of maximum urinary flow rate （Qmax）, prostate symptom score （IPSS）, quality of life Index （QOL）, residual urine （RUV）, PSA, IGF - 1 and IGFBP -3 were also observed before and after treatment in two groups. Results After treatment, the blood loss, operation time, resection quality, bladder irrigation time, indwelling catheter time and hospital stay were significantly less or shorter in the observation group than those in the control group （ all P 〈 0.05 ） , but there was not statistically significant difference in the incidence of complication between two groups （P 〉 O. 05）. After treatment, the levels of IPSS, QOL, RUV, PSA and IGF - 1 were significantly lower in two groups than those before treatment （ all P 〈 0.05 ）, and the levels of Qmax sig- nificantly increased in two groups compared with those before treatment （ all P 〈 O. 05 ） , while the levels of PSA, IGF - 1 and IGFBP -3 in observation group were significantly reduced compared with the control group （all P 〈0.01 ） , there was no sig- nificant difference in the levels of IPSS, QOL and RUV between the two groups （ all P 〉 O.

关 键 词：良性前列腺增生症 尿道钬激光前列腺剜除术 胰岛素生长因子-1 胰岛素生长因子结合蛋白-3 

分 类 号：R699.8[医药卫生—泌尿科学]