钬激光前列腺剜除术治疗前列腺增生的手术效率及学习曲线探讨  

Efficacy and learning curve of holmium laser enucleation of prostate on patients with benign prostatic hyperplasia

作　　者：沈锋[1] 缪惠东[1] 薛亚岗[1] 袁晓林[1] Shen Feng;Miao Huidong;Xue Yagang;Yuan Xiaolin(Department of Urology,the First People's Hospital of Zhangjiagang City,Suzhou 215600 China)

机构地区：[1]张家港市第一人民医院(苏州大学附属张家港医院)泌尿外科,215600

出　　处：《国际泌尿系统杂志》2019年第4期633-636,共4页International Journal of Urology and Nephrology

摘　　要：目的评价钬激光前列腺剜除术治疗前列腺增生的手术效率及学习曲线.方法本研究回顾性地分析了一名具有丰富TURP术经验的泌尿外科手术医师使用钬激光前列腺剜除术治疗前列腺增生的前60例患者的手术资料,按手术的时间顺序分为早期组、中期组、后期组,每组20例患者.比较三组患者手术时间、术后血红蛋白水平、留置尿管时间、术后住院时间、手术剜除效率、血红蛋白下降值,利用手术剜除效率拟合学习曲线.结果早期组、中期组、后期组手术剜除前列腺时间逐渐缩短,剜除效率逐渐增高,差异具有统计学意义(P<0.05);而三组间手术时间、组织粉碎时间、血红蛋白下降值、留置尿管时间、术后住院时间差异无统计学意义(P>0.05).结论有TURP术经验的手术医师学习HoLEP术是可行的,且手术经验的积攒会逐渐提高剜除效率.Objective To evalutate the efficacy and learning curve of holmium laser enuclea-tion of prostate on patients with benign prostatic hyperplasia (BPH). Methods We retrospectively analyzed the first 60 surgical cases of a surgeon who was experienced on transurethral resection of pros-tate ( TURP) and newly using holmium laser enucleation of prostate ( HoLEP). Participants were di-vided into three groups ( the early surgery group, middle group and late stage group), based on surgi-cal time. There were 20 patients in each group, while the operative duration time, postoperative hemo-globin, urethral catheterization duration time, postoperative hospitalization duration, enucleation effica-cy, and the change of hemoglobin were compared. The learning curve was evaluated by enucleation ef-ficacy. Results The early group, middle group and late surgical enucleation of the prostate enuclea-tion time gradually shortened, the efficiency gradually increased, there were statistically significant differences ( P<0. 05 ), and the time between the three groups, the organization operation grinding time, decrease in hemoglobin, indwelling catheter time, postoperative hospitalization time had no sig-nificant difference ( P>0. 05 ). Conclusions It is available for experienced TURP surgeon to use HoLEP on patients with BPH. As the surgeon become experienced, the enucleation efficacy is satis-fied.

关 键 词：前列腺增生 激光 固体 前列腺切除术 

分 类 号：R699.8[医药卫生—泌尿科学]