经尿道钬激光“五步法”前列腺剜除术治疗老年前列腺增生症890例报告  

A report of 890 cases of senile benign prostatic hyperplasia treated with“five-step”transurethral holmium laser holistic enucleation

作　　者：李永光 余浪 刘晓雨 慕莹 张恒志 刘庆 LI Yong-guang;YU Lang;LIU Xiao-yu;MU Ying;ZHANG Heng-zhi;LIU Qing(Department of Urology,Guihang Guiyang Hospital,Guiyang 550009,China)

机构地区：[1]贵航贵阳医院泌尿外科,贵州贵阳550009

出　　处：《现代泌尿外科杂志》2020年第7期609-613,共5页Journal of Modern Urology

基　　金：贵阳市科技计划项目(No.20161001)54号。

摘　　要：目的总结经尿道钬激光前列腺剜除术(HoLEP)“五步法”治疗前列腺增生症(BPH)的疗效和安全性。方法回顾性分析2014年9月至2019年6月间接受HoLEP手术的890例BPH患者的临床资料,了解HoLEP手术时间、切除前列腺重量、切除前列腺重量/术前前列腺重量百分比、手术前后血红蛋白(Hb)变化、术后随访3~6个月前列腺症状评分(NIH-IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、剩余尿量(PVR)变化。通过文献与国内4家开展HoLEP较早医院的数据进行对比。结果手术均顺利完成,平均手术时间(30±15)min;切除前列腺重量/术前前列腺重量百分比49.3%~67.1%;术后冲洗膀胱时间6~12 h;手术前后血红蛋白无显著变化(P>0.05);NIH-IPSS、QOL、Qmax、PVR与手术前比较均显著改善。结论“五步法”整体剜除术治疗老年BPH具有安全性高、剜除时间短、术后恢复快、并发症少等优点,是一种更好的手术方案。Objective To evaluate the efficacy and safety of holmium laser prostate enucleation(HoLEP)in the treatment of benign prostate hyperplasis(BPH).Methods Clinical data of 890 BPH cases treated with“five-step”HoLEP during Sep.2014 and Jun.2019 were retrospectively analyzed.The operation time,weight of resected prostate,weight of resected prostate/preoperative prostate weight,hemoglobin(Hb)changes before and after operation,preoperative prostate symptom score(NIH-IPSS),quality of score(QOL),maximum urinary flow rate(Qmax),and residual urine volume(PVR)were reviewed.The data collected from literature and data collected from 4 other hospitals were compared.Results All operations were completed successfully.The average operation time was(30±15)min,weight of resected prostate/preoperative prostate weight was(49.3%-67.1%),and postoperative bladder irrigation time was 6-12 h.There was no signifucant change in Hb before and after surgery(P>0.05).NIH-IPSS,QOL,Qmax and PVR were signifucantly improved after surgery.Conclution The“five-step”HoLEP is safe and effective in the treatment of BPH,which has advantages of short enucleation time,fast recovery and few complications.

关 键 词：钬激光 前列腺增生 五步法 整体剜除 安全性 

分 类 号：R699.8[医药卫生—泌尿科学]