经尿道钬激光前列腺剜除术与经尿道等离子前列腺剜除术治疗前列腺增生的疗效比较  

Comparison of holmium laser enucleation of prostate and plasmakinetic enucleation of prostate for the treatment of benign prostatic hyperplasia

作　　者：张豪杰[1] 盛璐[1] 陈然[1] 陶晶[1] 孙忠全[1] 钱伟庆[1] 

机构地区：[1]复旦大学附属华东医院泌尿外科,上海200040

出　　处：《中国临床医学》2016年第5期636-639,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨经尿道钬激光前列腺剜除术(HOLEP)与经尿道等离子前列腺剜除术(PKERP)治疗前列腺增生症(BPH)的安全性和疗效。方法:将80例前列腺增生症患者随机分为两组,每组40例,分别用HOLEP及PKERP治疗。比较两种手术方法的手术时间、前列腺切除质量、术前后血红蛋白变化、膀胱冲洗时间、住院时间、手术并发症及近期疗效等。术后3个月和6个月随访最大尿流率(Qmax)、残余尿量(PVR)、术前国际前列腺症状评分(IPSS)、生活质量评分(QOL)。结果:HOLEP组和PKERP组平均手术时间分别为(75.60±16.95)min和(95.30±21.57)min,膀胱冲洗时间分别为(16.4±4.67)h和(18.65±3.67)h,平均住院时间分别为(7.66±0.87)d和(8.19±1.2)d,血红蛋白分别下降(7.35±6.14)g/L和(10.25±6.43)g/L,差异均有统计学意义(P<0.05)。两组前列腺切除质量、平均留置导尿管时间、并发症发生率差异无统计学意义。两组患者术前IPSS、QOL、Qmax、PVR与术后3、6个月差异均有统计学意义(P<0.05),但两组差异无统计学意义。结论:HOLEP组和PKERP组对BPH的短期疗效相当。HOLEP组出血更少,手术时间、膀胱冲洗时间、住院时间更短。因此,HOLEP可能成为BPH手术的金标准;而PKERP在无钬激光时可以应用。Objective：To compare the safety and efficacy of the holmium laser enucleation of prostate（HOLEP）and plasmakinetic enucleation of prostate（PKERP）for the treatment of benign prostatic hyperplasia（BPH）.Methods：A total of80 patients with BPH were selected and randomly divided into two groups,with 40 cases in each group,and one group was received HOLEP treatment,while the other group was received PKERP treatment.The operation time,surgery quality,change of hemoglobin before and after surgery,bladder irrigation time,hospitalization time,surgical complications and shortterm efficacy of two methods were compared.Results：The operation time in HOLEP group and PKERP group was（75.60±16.95）min and（95.30±21.57）min,respectively.The bladder irrigation time was（16.4±4.67）h and（18.65±3.67）h,respectively.The average hospital stay time was（7.66±0.87）d and（8.19±1.2）d,respectively.The change of hemoglobin was（7.35±6.14）g/L and（10.25±6.43）g/L,respectively（P〈0.05）.There was no statistical significance of surgery quality,average catheter indwelling time and incidence rate of complications found in two groups.The statistical significances were found between the IPSS,QOL,Qmax and PVR before surgery and the 3rd and 6th months after surgery（P〈0.05）,while nostatistical difference was found between two groups.Conclusions：The HOLEP group and PKERP group had relatively equal short-term treatment efficacy,while the HOLEP group with less bleeding,short operation time,short bladder irrigation time,and short hospitalization time.Therefore,the HOLEP can be the golden standard of BPH surgery,while PKERP can be applied in surgery without holmium laser.

关 键 词：前列腺剜除 钬激光 等离子 

分 类 号：R699.8[医药卫生—泌尿科学]