经尿道前列腺钬激光剜除术与双波长龙激光汽化术治疗大体积前列腺的对比研究  

Comparative study of transurethral holmium laser enucleation and dual-wavelength dragon laser vaporization for large-volume benign prostatic hyperplasia

作　　者：万岳明 廖春望 何垚[2,3] 王思远 易小春 彭克亮 彭云 WAN Yueming;LIAO Chunwang;HE Yao;WANG Siyuan;YI Xiaochun;PENG Keliang;PENG Yun(Department of Urology,The Second People's Hospital of Yueyang City,Hunan Normal University,Yueyang 414000,China;Department of Urology,Xiangya Hospital,Central South University,Changsha 410008,China;National Clinical Research Center for Geriatrics,Changsha 410008,China;Department of Geriatrics,Xiangya Hospital,University of China,Changsha 410008,China)

机构地区：[1]湖南师范大学附属岳阳市二人民医院泌尿外科,湖南岳阳414000 [2]中南大学湘雅医院泌尿外科,长沙410008 [3]国家老年疾病临床医学研究中心,长沙410008 [4]中南大学湘雅医院老年病科,长沙410008

出　　处：《河南大学学报（医学版）》2020年第4期252-255,共4页Journal of Henan University:Medical Science

基　　金：国家自然科学基金青年项目(81700663)。

摘　　要：〔目的〕探讨经尿道前列腺钬激光剜除术(HoLEP)和高功率双波长(980 nm/1470 nm)龙激光汽化术(DLVRP)在治疗大体积前列腺中的有效性和安全性。〔方法〕回顾性分析2016年4月至2019年10月期间接受两种手术的186例大体积前列腺(>80 mL)患者,其中包括DLVRP组102例,HoLEP组84例,并予以随访。分别统计比较DLVRP和HoLEP 2组患者的基线特征、围术期以及术后相关资料。〔结果〕DLVRP和HoLEP 2组患者在IPSS、QoL、Qmax和PVR等均较术前显著性改善,但2组之间无显著性差异。但HoLEP组比DLVRP组具有更短的手术时间〔(66.40±21.73)min vs(76.05±20.99)min,P=0.002〕、更高的尿失禁发生率〔18(21.4%)vs 10(9.8%),P=0.027〕。另外,DLVRP组的逆行射精发生率同样较低,但无统计学差异(P=0.058)。〔结论〕DLVRP和HoLEP在治疗>80 mL的前列腺增生患者均有较好疗效,而DLVRP在预防术后尿失禁等方面具有一定的优势。〔Objective〕To investigate the efficacy and safety of transurethral holmium prostate holmium laser enucleation(HoLEP)and high-power dual-wavelength(980 nm/1470 nm)dragon laser vaporization(DLVRP)in the treatment of large prostate.〔Methods〕A retrospective analysis of 186 patients with large-volume prostate(>80 mL)undergoing two operations from April 2016 to October 2019,including 102 cases in the DLVRP group and 84 cases in the HoLEP group,was followed up.The baseline characteristics,perioperative period and postoperative related data of DLVRP and HoLEP patients were statistically compared.〔Results〕The IPSS,QoL,Qmax and PVR of the two groups of DLVRP and HoLEP patients were significantly improved compared with those before surgery,but there was no significant difference between the two groups.However,the HoLEP group had a shorter operation time than the DLVRP group〔(66.40±21.73)min vs(76.05±20.99)min,P=0.002〕,and a higher incidence of incontinence〔18(21.4%)vs 10(9.8%),P=0.027〕.〔Conclusion〕DLVRP and HoLEP have a good effect in the treatment of patients with benign prostatic hyperplasia>80 mL,and DLVRP has certain advantages in improving postoperative urinary incontinence.

关 键 词：双波长龙激光汽化术 经尿道前列腺钬激光剜除术 大体积前列腺 逆行射精 尿失禁 

分 类 号：R697.32[医药卫生—泌尿科学]