经尿道前列腺1470激光切除术与等离子电切术治疗前列腺增生疗效比较  

Comparison on the efficacy of transurethral 1470 nm laser enucleation and plasma electrotomy of the prostate in the treatment of prostatic hyperplasia

作　　者：朱元全 崔庆鹏 刘孝东[2] 罗芳 ZHU Yuan-quan;CUI Qing-peng;LIU Xiao-dong;LUO Fang(Department of Urology,Yunnan Third People's Hospital,Kunming 650032,Yunnan,CHINA;Department of Urology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,Yunnan,CHINA;Department of Gynaecology,Yunnan Third People's Hospital,Kunming 650032,Yunnan,CHINA)

机构地区：[1]云南省第三人民医院泌尿外科,云南昆明650032 [2]昆明医科大学第一附属医院泌尿外科,云南昆明650032 [3]云南省第三人民医院妇科,云南昆明650032

出　　处：《海南医学》2020年第22期2919-2922,共4页Hainan Medical Journal

基　　金：国家自然科学基金(编号:8186045);云南省应用基础研究项目(编号:昆医联合专项2017FE648);昆明医科大学博士基金(编号:2015BS026)。

摘　　要：目的比较经尿道前列腺1470纳米激光剜除术与等离子切除术治疗良性前列腺增生(BPH)的临床疗效及安全性。方法回顾性分析云南省第三人民医院泌尿外科2015年6月至2019年6月4年期间收治的234例BPH患者的临床资料,其中以136例采用等离子电切术患者为等离子组,98例采用1470纳米激光剜除术患者为纳米激光组。比较两组患者的手术时间、术中出血量、术后膀胱冲洗时间、留置尿管时间、术后尿流率及术后6个月内的并发症情况。结果234例患者手术均成功,无中转开放手术及严重前列腺电切综合征出现;纳米激光组和等离子组患者的手术时间分别为(61.72±16.72)h、(62.41±17.89)h,差异无统计学意义(P>0.05);纳米激光组和等离子组患者术中出血量[(33.42±6.57)mL vs(78.21±16.31)mL]、术后冲洗时间[(21.17±6.56)h vs(38.68±8.07)h]、留置尿管时间[(4.25±0.86)d vs(7.82±1.12)d]比较,纳米激光组明显少于或短于等离子组,差异均具有统计学意义(P<0.05);两组患者术后6个月内的并发症发生率比较差异无统计学意义(P>0.05)。结论与经尿道前列腺等离子电切术相比,1470激光法有更少的手术出血和更短的术后膀胱冲洗时间及尿管留置时间。Objective To compare the clinical efficacy and safety of transurethral 1470 nm laser enucleation and plasma electrotomy of the prostate in the treatment of benign prostatic hyperplasia(BPH).Methods A total of 234 patients with BPH admitted to Yunnan Third People's Hospital from June 2015 to June 2019 were randomly divided into two groups:136 patients in the plasma electrotomy group and 98 patients in the 1470 nm laser enucleation group.The operative time,intraoperative blood loss,postoperative bladder flushing time,indwelling catheter time,postoperative urine flow rate,and postoperative complications in 6 months were compared between the two groups.Results The operation was successful in 234 patients,and there was no transition to open or severe TUR syndrome.The operation time of patients in the 1470 nm laser enucleation group and the plasma electrotomy group was(61.72±16.72)h and(62.41±17.89)h,respectively,with no statistically significant difference(P>0.05).The intraoperative blood loss,postoperative bladder flushing time,urinary indwelling time in the 1470 nm laser enucleation group was(33.42±6.57)mL,(21.17±6.56)h,(4.25±0.86)d,which were significantly shorter or lower than(78.21±16.31)mL,(38.68±8.07)h,and(7.82±1.12)d in the plasma group(P<0.05).The postoperative complications within 6 months showed no statistically significant difference between the two groups(P>0.05).Conclusion Compared with transurethral plasma electrotomy,transurethral 1470 nm laser enucleation results in less intraoperative blood loss,shorter postoperative bladder flushing time and urinary indwelling time.

关 键 词：良性前列腺增生症 等离子电切术 1470纳米激光 激光剜除术 疗效 安全性 

分 类 号：R697.3[医药卫生—泌尿科学]