经尿道钬激光前列腺剜除术治疗良性前列腺增生的疗效及学习曲线  

Efficaly and learning curve holmium laser enucleation of proslate in the treatment of benign prostate hyperplasia

作　　者：张峻峰 周彦 薄隽杰[2] 杨正青 程辉 Zhang Junfeng;Zhou Yan;Bo Junjie;Yang Zhengqing;Cheng hui(SDepartment of Urology,hanghai Yangsi Hospital,Shanghai 200126,China;Department of Urology,Renji Hospital Affiliated to Shanghai Jiaotong University)

机构地区：[1]上海杨思医院泌尿外科,上海200126 [2]上海交通大学医学院附属仁济医院

出　　处：《中国男科学杂志》2019年第5期28-31,共4页Chinese Journal of Andrology

摘　　要：目的探讨钬激光前列腺剜除术(holmium laser enucleation of prostate,HoLEP)的手术效率、安全性及学习曲线。方法回顾性分析2015年4月~2017年4月采用HOLEP治疗的120例良性前列腺增生患者的临床资料。应用科医人(LUMINS)100+钬激光和大白鲨组织粉碎器对120位良性前列腺增生症的患者行经尿道钬激光前列腺剜除术和组织粉碎术。分别记录患者术前、术中及术后随访的临床资料,分析及评估HoLEP的疗效及安全性。结果120例手术均成功,手术时间31~150min,平均(76.1±39.2)min,切除腺体16~176g,平均(45.8±15.4)g。术后留置导尿24~216h,平均(72.5±23.2)h,术后留置导尿时间24~72h,平均(23.6±11.2)h,术后住院时间3~8 d,平均(3.45±1.25)d,血红蛋白平均降低(1.1±0.5)g/dL。术后IPSS、QOL、Qmax、PVR较术前明显改善(P<0.01)。术后并发症率低。结论经尿道前列腺钬激光剜除治疗良性前列腺增生疗效安全可靠,并发症少,剜除彻底,并且适应范围广,此术式有可能挑战TURP成为治疗BPH新的金标准,但HOLEP学习曲线长,操作难度大,有必要在有效提升泌尿外科医生HoLEP学习效率、缩短学习曲线时间进行探讨。Objective To study the efficacy,safety and learning curve of holmium laser enucleation of prostate.Methods Clinical data of 120 patients with benign prostate hyperplasia who were treated with LUMINS 100+holmium laser and great white shark tissue shredder from April 2015 to April 2017 were retrospective analyzed.Clinical data of preoperative,intraoperative and postoperative follow-up were recorded,and the efficacy and safety of HoLEP were comparatively evaluated.Results The operations were all for 120 patients.Average operation time was 31-150min(76.1±39.2),and 16~176g(45.8±l 5.4)g for gland resection.Postoperative indentation and catheterization lasted for 24〜216 hours(72.5 soil 23.2)h on average;postoperative indentation and catheterization lasted for 24-72 hours(23.6 soil 1.2)h on average;postoperative hospitalization lasted for 3〜8 days(3.45±1.25)d on average;hemoglobin decreased by L1±0.5 g/dL on average.IPSS,QOL,Qmax and PVR were significantly improved after operation(P<0.01).Postoperative complication rate was low.Conclusion Transurethral holmium laser enucleation for the treatment ofbenign prostatic hyperplasia is safe and reliable,with few complications,complete enucleation and wide range of application.How to effectively improve the learning efficiency of urological surgeon.HoLEP may challenge TURP and become a new gold standard for the treatment ofBPH.

关 键 词：前列腺增生 钬激光剜除 学习曲线 

分 类 号：R697.32[医药卫生—泌尿科学] R699.8[医药卫生—外科学]