经尿道前列腺钬激光剜除术治疗大体积前列腺疗效及对患者尿流动力学和血清T-PSA F-PSA水平的影响  

Curative Effect of Holmium Laser Enucleation of the Prostate in the Treatment of Large-Volume Prostate and Its Influence on Urodynamics Serum T-PSA and F-PSA Levels

作　　者：黄尉 韩均凌 沈宏峰 HUANG Wei;HAN Junling;SHEN Hongfeng(The 928 Hospital of Joint Service Logistic Support Forces of the People's Liberation Army, Hainan Haikou 570206, China)

机构地区：[1]解放军联勤保障部队928医院,海南海口570206

出　　处：《河北医学》2021年第11期1807-1811,共5页Hebei Medicine

基　　金：海南省重点研发计划项目,(编号:ZDYF2017125)。

摘　　要：目的:研究经尿道钬激光前列腺剜除术(Holmium Laser Enucleationof The Prostate,HOLEP)治疗大体积前列腺疗效及对患者尿流动力学和血清总前列腺特异性抗原(Total Prostate Specific Antigen,T-PSA)、游离前列腺特异性抗原(Free Prostate Specific Antigen,F-PSA)水平的影响。方法:选取2018年1月至2020年12月在我院就诊的男性良性前列腺增生(Benign Prostate Hyperplasia,BPH)患者107例,简单随机分组,分为对照组53例和观察组54例。其中对照组采用经尿道前列腺电切术(Transurethral Resection Prostate,TURP),观察组采用经尿道钬激光前列腺剜除术(Holmium Laser Enucleationof The Prostate,HOLEP),比较两组患者手术指标;术后1个月,比较两组患者血清T-PSA、F-PSA水平;术后3个月,比较两组患者尿流动力学、性功能及术后并发症发生率。结果:观察组手术时间显著久于对照组(P<0.05),出血量、膀胱冲洗时间、导尿管滞留时间、住院时间均显著低于对照组(P<0.05);术后3个月,观察组尿流动力学最大尿流量、最大膀胱容量显著高于对照组(P<0.05),残余尿量显著低于对照组(P<0.05);术后1个月,观察组患者血清T-PSA、F-PSA水平显著低于对照组(P<0.05);术后3个月,观察组性功能勃起功能评分表(International Index of Erectile Function 5,IIEF-5)、射精功能评分表(Chinese Index of Sexual Function for Premature Ejaculation,CIPE)评分均显著高于对照组(P<0.05);术后,观察组术后并发症发生率显著低于对照组(P<0.05)。结论:HOLEP治疗大体积前列腺患者临床治疗安全性较高,能改善患者尿流动力学,降低患者T-PSA、F-PSA水平,减少术后并发症。Objective:To study the curative effect of holmium laser enucleation of the prostate(HOLEP)in the treatment of large-volume prostate,and its influence on urodynamics,serum total prostate specific antigen(T-PSA)and free prostate specific antigen(F-PSA)levels.Methods:A total of 107 male patients with benign prostate hyperplasia(BPH)treated in the hospital between January 2018 and December 2020 were enrolled in and randomly divided into control group(53 cases)and observation group(54 cases).The control group was treated with transurethral resection prostate(TURP),while observation group was treated with HOLEP.The surgical indexes,serum T-PSA and F-PSA levels,urodynamics,sexual function and the incidence of postoperative complications in the two groups were compared.Results:Compared with the control group,the observation group had significantly longer operation time,bladder irrigation time,catheter indwelling time and hospital stay,and significantly less blood loss(P<0.05).At 3 months after surgery,the observation group had significantly larger urine flow and bladder volume,and significantly less residual urine than the control group(P<0.05).At 1 month after surgery,the observation group had significantly lower serum T-PSA and F-PSA levels than the control group(P<0.05).At 3 months after surgery,the International Index of Erectile Function 5(IIEF-5)scores and Chinese Index of Sexual Function for Premature Ejaculation(CIPE)scores of the observation group were significantly higher than those of the control group(P<0.05),and incidence of postoperative complications was significantly lower than the control group(P<0.05).Conclusion:HOLEP is safer in treating patients with large-volume prostate.It can improve urodynamics,reduce levels of T-PSA and F-PSA,and reduce postoperative complications.

关 键 词：经尿道前列腺钬激光剜除术 大体积前列腺 尿流动力学 总前列腺特异性抗原 游离前列腺特异性抗原 

分 类 号：R69[医药卫生—泌尿科学]