经尿道前列腺等离子与钬激光剜除术治疗前列腺增生的比较  

Comparison of transurethral enucleation of the prostate and transurethral prostate high power holmium laser deburring for the treatment of benign prostatic hyperplasia

作　　者：蔡平昌[1] 柏明军[2] 高虹[1] 何江波[1] 陈定华[1] 邹红东[1] 李欣 胡成[3] 李腾成[3] Cai Pingchang;Bai Mingjun;Gao Hong;He Jiangbo;Chen Dinghua;Zou Hongdong;Li Xin;Hu Cheng;Li Tengcheng(Department of Urology,Fourth People's Hospital of Guiyang,550002 Guizhou,China;Department of Vascular Surgery,the Third Affiliated Hospital of Sun Yat-sen University,510630 Guangzhou,China;Department of Urology,the Third Affiliated Hospital of Sun Yat-sen University,510630 Guangzhou,China)

机构地区：[1]贵阳市第四人民医院泌尿外科,550002 [2]中山大学附属第三医院介入血管科,广州510630 [3]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2020年第6期448-451,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：2019年中山大学校级本科教学质量工程与教学改革项目(82000-31911131)。

摘　　要：目的探讨基层医院开展经尿道前列腺等离子剜除术(TUEP)和经尿道前列腺大功率钬激光剜除术(HoLEP)治疗老年男性前列腺增生患者的安全性和有效性。方法回顾性分析贵阳市第四人民医院250例前列腺增生患者的住院病例资料,其中等离子组156例,钬激光组94例。统计比较两组患者的临床资料。结果所有患者手术均取得成功,无中转开放手术病例,术后随访至少12个月。等离子组与钬激光组的基线资料比较差异无统计学意义(P>0.05)。钬激光组患者术后血红蛋白变化([1.2±0.5)g/L vs(2.3±0.8)g/L]和术后血生化血钠降低指数([1.9±0.5)mmol/L vs(3.1±1.5)mmol/L]变化较等离子组患者小,术后置尿管时间([3.4±0.8)d vs(5.3±1.4)d]和住院时间([4.5±1.9)d vs(6.7±2.5)d]比等离子组患者短,差异均有统计学意义(P<0.001)。等离子组与钬激光组患者术后3个月IPSS、RUV、Qmax和QOL均较术前改善(P<0.05),随访期间无尿失禁发生,远期并发症差异无统计学意义(6/156 vs 4/94,P>0.05)。结论TUEP与HoLEP治疗前列腺增生均安全、有效,远期疗效需进一步研究证实。Objective To compare the safety and efficacy of transurethral enucleation of the prostate(TUEP)and transurethral prostate high power holmium laser deburring(HoLEP)for the treatment of benign prostatic hyperplasia in the primary hospital.Methods 250 patients with benign prostatic hyperplasia were retrospectively included in the study,including 156 cases in the TUEP group and 94 cases in the HoLEP group.The clinical data were compared between the two groups.Results All operations were successful,no case was transfered to open surgery,and followed up at least 12 monthes.There was no significant difference in the baseline data between the two groups(P>0.05).The hemoglobin changes[(1.2±0.5)g/L vs(2.3±0.8)g/L],postoperative blood biochemical sodium reduction index[(1.9±0.5)mmol/L vs(3.1±1.5)mmol/L],and the postoperative catheter indwelling time[(3.4±0.8)days vs(5.3±1.4)days],hospitalization time[(4.5±1.9)days vs(6.7±2.5)days]in the HoLEP group were smaller or shorter than those in the TUEP group,the differences were statistically significant(P<0.001).The IPSS,RUV,Qmax and QOL of the patients in both groups were improved compared with those before operation(P<0.05).There was no urinary incontinence during the follow-up period and long-term complications were not different between the two groups(6/156 vs 4/94,P>0.05).Conclusion TUEP and HoLEP are both safe and effective for the treatment of benign prostatic hyperplasia patients in the primary hospitals,and long-term effects need to be confirmed by further studies.

关 键 词：等离子 钬激光 前列腺剜除术 

分 类 号：R699.8[医药卫生—泌尿科学]