高海拔地区980nm DiLEP与TUPKP治疗BPH患者的疗效和安全性比较  

Comparison of the Efficacy and Safety of 980nm Di LEP and TUPKP in the Treatment of BPH in High Altitude Areas

作　　者：朱明挺[1] 乜国雁[1] 贾晶蓉 朱付勇 刘智明[1] Zhu Mingting;Nie Guoyan;Jia Jingrong;Zhu Fuyong;Liu Zhiming(Urology Department of The People's Hospital of Qinghai,810007)

机构地区：[1]青海省人民医院泌尿外科,810007

出　　处：《高原医学杂志》2021年第1期23-27,共5页Journal of High Altitude Medicine

基　　金：青海省卫生计生系统指导性计划课题(2018-wjzdx-20)。

摘　　要：目的:比较高海拔地区经尿道980nm红激光前列腺剜除术(DiLEP)与经尿道前列腺等离子双极电切术(TUPKP)对良性前列腺增生症(Benign prostatic hyperplasia,BPH)患者的疗效和安全性。方法:分析我院于2016年6月—2019年9月收治的接受DiLEP治疗的BPH患者与接受TUPKP治疗的BPH患者的临床资料,患者均来自2400m以上的高海拔地区,分别为观察组(108例)和对照组(106例),比较两组患者治疗疗效、术后血红蛋白(Hb)下降值、手术相关指标、并发症发生情况及国际前列腺症状评分(IPSS)、生活质量指数评分(QOL)。结果:观察组进行DiLEP的手术时长、术中冲洗液使用总量、术后Hb下降值、血钠(Na)下降值、导尿管留置时长及住院时长均明显低于对照组(P<0.001);切除前列腺质量两组比较无明显差异(P>0.05);观察组术中发生电切综合征(TURS)、前列腺穿孔、膀胱颈损伤、闭孔反射及术后发生尿失禁、尿道狭窄、膀胱颈挛缩、血尿等并发症的风险明显低于对照组(P<0.05);术后随访(6~48)个月,观察组患者术前及术后3个月、术后6个月时IPSS评分、QQL评分与对照组比较无明显差异(P>0.05)。结论:在高海拔地区DiLEP相比TUPKP临床效果等同,但其术中出血量少、手术和住院时间短、并发症发生率低,是高原低氧地区治疗BPH的更优术式。Objective:The aim of this study is to compare the efficacy and safety of transurethral 980 nm red laser enucleation of the prostate(DiLEP)and transurethral plasma bipolar resection of the prostate(TUPKP)in patients with benign prostatic hyperplasia(BPH)in high altitude areas.Methods:The data of 108 patients with DiLEP and 106 patients with TUPKP who were admitted to The People’s Hospital of Qinghai from June 2016 to September 2019 were analyzed as observation group and control group respectively,all of whom were from regions above 2400 m altitude.The treatment efficacy,postoperative hemoglobin(Hb)value,operation-related indicators,and the safety of complications,as well as the International Prostate Symptom Score(IPSS)and Quality of Life Score(QOL)were compared between the two groups.Results:The length of DiLEP operation,total amount of lavage fluid used during the operation,postoperative hemoglobin decline,blood sodium decline,catheter indwelling length and length of hospital stay in the observation group were significantly lower than those in the control group(P<0.001);And there was no significant difference in the quality of prostate resection between the two groups(P>0.05);The observation group had significant lower risks of complications such as TURS,prostate perforation,bladder neck injury,obturator reflex,and postoperative urinary incontinence,urethral stricture,bladder neck contracture,hematuria,etc.than the control group(P<0.05).After follow-up for(6~48)months,the IPSS score and QOL score of the observation group were not significantly different from those of the control group(P>0.05).Conclusion:In high altitude areas,DiLEP has the same clinical effect as TUPKP,but it has the advantages of less intraoperative blood loss,shorter operation and hospitalization time,and lower complications incidence,which is a better surgical treatment in the plateau hypoxia area for BPH.

关 键 词：良性前列腺增生症 等离子电切术 980nm红激光 疗效 

分 类 号：R697.32[医药卫生—泌尿科学] R616.4[医药卫生—外科学]