经尿道前列腺钬激光剜除术治疗BPH的疗效评价  

作　　者：孙灵军[1] 陈涛伟[1] 孙树本[1] 虞建达[1] 李涛 

机构地区：[1]宁波大学医学院附属医院,315000

出　　处：《浙江临床医学》2021年第4期505-507,共3页Zhejiang Clinical Medical Journal

基　　金：宁波市自然科学基金资助项目(2017A610191)。

摘　　要：目的探讨良性前列腺增生症(BPH)经尿道前列腺钬激光剜除术(HoLEP)治疗的安全性和疗效.方法收集2016年9月1日至2020年1月31日宁波大学医学院附属医院收治的55例高龄(≥80岁)BPH患者临床资料,根据手术方式分为HoLEP组(28例)和TURP组(27例).观察两组的手术时间、血红蛋白(Hb)下降值、红细胞压积(PCV)变化、膀胱连续冲洗时间、导尿管留置时间、术后住院时间及术中并发症,以评价手术安全性.术后随访6~45个月,统计国际前列腺症状评分(IPSS)和生活质量评分(QOL),观察术后并发症情况,以评价手术疗效.结果55例高龄患者均安全完成手术,两组各出现1例术中并发症.两组的手术时间、术中并发症及术后住院时间比较,差异无统计学意义(P>0.05).两组Hb下降值、PCV变化、膀胱持续冲洗时间及留置导尿时间比较,HoLEP组均优于TURP组.术后6个月随访时,IPSS及QOL评分与治疗前比较有显著改善,但组间比较差异无统计学意义(P>0.05).持续随访术后并发症,HoLEP组压力性尿失禁2例、尿道狭窄1例、膀胱颈挛缩1例;TURP组尿道狭窄2例、出院后1周再次出血1例.结论前列腺钬激光剜除术治疗高龄BPH患者安全有效.Objective To explore the safety and efficacy of transurethral holmiuni laser enucleation of the prostate(HoLEP)in the treatment with benign prostatic hyperplasia(BPH).Methods The clinical data of 55 elderly(≥80 years old)BPH patients admitted to the Affiliated Hospital of Ningbo University School of Medicine from September 1,2016 to January 31,2020 were collected and divided into HoLEP group(28 cases)and TURP group(27 cases).The operation tim e,hemoglobin(Hb)decrease,hematocrit(PCV)change,continuous bladder irrigation time,catheter indwelling time,postoperative hospital stay and intraoperative complications were observed in the two groups to evaluate the safety of the operation.The postoperative follow-up was 6 to 45 months,and the International Prostate Symptom Score(IPSS)and Quality of Life Score(QOL)were calculated to observe the postoperative complications to evaluate the efficacy of the operation.Results All 55 elderly patients completed the operation safely,and 1 case of intraoperative complications occurred in each of the two groups.There was no statistically significant difference in the operation time,intraoperative complications and postoperative hospital stay between the two groups(P>0.05).Comparison of Hb drop,PCV change,continuous bladder flushing time and indwelling catheterization time between the two groups showed that the HoLEP group was better than the TURP group.At the 6-month follow-up,IPSS and QOL scores were significantly improved compared with those before treatment,but there was no statistically significant difference between the groups(P>0.05).Continuous follow-up of postoperative complications included 2 cases of stress urinary incontinence,1 case of urethral stricture,1 case of bladder neck contracture in the HoLEP group;2 cases of urethral stricture in the TURP group,and 1 case of rebleeding 1 week after discharge.Conclusion Holmium laser enucleation of the prostate is safe and effective in the treatment of elderly patients with BPH.

关 键 词：前列腺增生 高龄 前列腺钬激光剜除术 

分 类 号：R69[医药卫生—泌尿科学]