1470 nm激光顺行法前列腺剜除术治疗前列腺增生症的疗效观察及对患者应激反应、生活质量的影响  

Effect of 1470nm laser anterograde enucleation on BPH and its influence on stress response and quality of life

作　　者：厉进雪 曹勇 厉波 Li Jinxue;Cao Yong;Li Bo(Department of Urinary Surgery,Rizhao Central Hospital,Rizhao,Shandong 276800,China)

机构地区：[1]日照市中心医院泌尿外科,山东省276800

出　　处：《中国基层医药》2020年第14期1720-1724,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察1470 nm激光顺行法前列腺剜除术治疗前列腺增生症的疗效及对应激反应、生活质量的影响。方法选择2018年7月至2019年5月日照市中心医院收治的良性前列腺增生症患者90例为研究对象,根据治疗方法的不同分为两组各45例。观察组采用1470 nm激光顺行法前列腺剜除术。对照组采用经尿道等离子电切术。比较两组手术时间、膀胱冲洗时间、留置导尿管时间及住院时间;比较两组手术应激反应情况,包括磷酸肌酸激酶(CK)、C反应蛋白(CRP)、皮质醇及肾上腺素水平;随访6个月,比较两组国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率测定(Qmax)及残余尿测定(PVR)的差异;比较两组手术并发症发生率。结果观察组手术时间明显长于对照组[(80.2±23.5)min比(69.5±19.2)min],膀胱冲洗时间[(1.4±0.3)d比(1.7±0.4)d]、留置导尿管时间[(5.2±0.9)d比(6.2±1.1)d]及住院时间[(6.7±1.1)d比(8.3±1.6)d]明显短于对照组,差异均有统计学意义(t=4.576、4.025、4.719、5.528,均P<0.05)。与术前比较,两组术后CK[(100.5±11.5)U/L比(86.5±9.2)U/L,(103.5±15.4)U/L比(87.3±9.9)U/L]、CRP[(14.5±2.9)mg/L比(12.5±2.5)mg/L,(16.3±3.1)mg/L比(12.6±1.9)mg/L]、皮质醇[(285.2±45.6)ng/mL比(235.6±36.5)ng/mL,(310.2±55.6)ng/L比(241.6±43.2)ng/L]及肾上腺素水平[(57.8±8.7)pg/mL比(51.5±7.8)pg/mL,(62.5±9.9)pg/L比(50.9±8.9)pg/L]均显著升高,差异均有统计学意义(t=6.377、6.478、3.504、5.125、5.696、6.752、3.617、4.992,均P<0.05)。组间比较,观察组术后CRP、皮质醇及肾上腺素水平均显著低于对照组,差异均有统计学意义(t=2.845、2.332、2.392,均P<0.05)。术后,两组IPSS评分[(7.5±1.6)分比(24.2±6.8)分,(7.7±1.9)分比(23.8±7.6)分]、QOL评分[(1.4±0.5)分比(5.0±0.6)分,(1.6±0.6)分比(4.9±0.7)分]均显著降低,Qmax[(21.7±3.5)mL/s比(7.5±2.1)mL/s,(22.1±4.3)mL/s比(7.8±2.5)mL/s]显著升高,PVR[(28.6±7.2)mL比(111.2±26.5)mL,(29.3±8.1)Objective To observe the effect of 1470nm laser anterograde enucleation on benign prostatic hypertrophy(BPH),and its influence on stress response and quality of life.Methods From July 2018 to May 2019,90 patients with BPH diagnosed and treated by urology department in Rizhao Central Hospital were selected in the study.According to the different treatment methods,they were divided into two groups,with 45 cases in each group.In the observation group,1470nm laser anterograde enucleation of prostate was used.The control group was treated with transurethral plasma resection.The operation time,bladder flushing time,indwelling catheter time and hospitalization time of the two groups were compared.The stress responses of the two groups were compared,including CK,CRP,cortisol and adrenaline levels.The differences of IPSS score,QOL score,maximum urine flow rate(Qmax)and residual urine test(PVR)between the two groups were compared after 6 months of follow-up.The incidence of complications of the two groups was compared.Results The operation time of the observation group was significantly longer than that of the control group[(80.2±23.5)min vs.(69.5±19.2)min],and the bladder washing time[(1.4±0.3)d vs.(1.7±0.4)d],indwelling catheter time[(5.2±0.9)d vs.(6.2±1.1)d]and hospitalization time[(6.7±1.1)d vs.(8.3±1.6)d]were significantly shorter than those of the control group(t=4.576,4.025,4.719,5.528,all P<0.05).After operation,the levels of CK[(100.5±11.5)U/L vs.(86.5±9.2)U/L,(103.5±15.4)U/L vs.(87.3±9.9)U/L],CRP[(14.5±2.9)mg/L vs.(12.5±2.5)mg/L,(16.3±3.1)mg/L vs.(12.6±1.9)mg/L],cortisol[(285.2±45.6)ng/mL vs.(235.6±36.5)ng/mL,(310.2±55.6)ng/L vs.(241.6±43.2)ng/L]and adrenaline[(57.8±8.7)pg/mL vs.(51.5±7.8)pg/mL,(62.5±9.9)pg/L vs.(50.9±8.9)pg/L]in the two groups were significantly higher than those before operation(t=6.377,6.478,3.504,5.125,5.696,6.752,3.617,4.992,all P<0.05).The levels of CRP,cortisol and adrenaline in the observation group were significantly lower than those in the control group(all P<0.0

关 键 词：前列腺增生症 前列腺切除术 激光治疗术 疗效 生活质量 应激反应 国际前列腺症状评分 

分 类 号：R699.8[医药卫生—泌尿科学]