摩西钬激光前列腺剜除术治疗良性前列腺增生伴急性尿潴留患者的安全性和有效性分析  

A Study of the Safety and Efficacy of MoLEP for Patients with Acute Urinary Retention Caused by Benign Prostatic Hyperplasia

作　　者：吴洋洋 吕凯凯 杨国荣 赖文辉 郝晓伟 黄帅 罗振君 张春燕[5] 宋涛 袁清[1,2] WU Yangyang;LYU Kaikai;YANG Guorong;LAI Wenhui;HAO Xiaowei;HUANG Shuai;LUO Zhenjun;ZHANG Chunyan;SONG Tao;YUAN Qing(Senior Department of Urology,the Third Medical Center of PLA General Hospital,Beijing100039,China;Graduate School,Medical School of Chinese PLA,Beijing 100853,China;Graduate School,Hebei North University,Zhangjiakou 075051,China;Clinical Medicine,Weifang Medical University,Weifang 261053,China;Birth Defect Prevention and Control Technology Research Center,Medical Innovation Research Divisionof Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第三医学中心泌尿外科医学部,北京100039 [2]中国人民解放军医学院研究生院,北京100853 [3]河北北方学院研究生学院,河北张家口075000 [4]潍坊医学院临床医学院,山东潍坊261053 [5]解放军总医院医学创新部出生缺陷防控技术研究中心,北京100853

出　　处：《标记免疫分析与临床》2023年第2期223-227,236,共6页Labeled Immunoassays and Clinical Medicine

基　　金：国家重点研发计划(编号:2021YFC2009300,2021YFC2009304,2022YFC3602900,2022YFC3602905);北京市科技新星计划交叉合作课题(编号:20220484230);解放军总医院青年自主创新科学基金(编号:22QNCZ016)。

摘　　要：目的评估摩西钬激光前列腺剜除术(MoLEP)治疗良性前列腺增生(BPH)合并急性尿潴留(AUR)患者的安全性和有效性,并探究术前尿管留置状态是否会对手术的短期预后产生影响。方法回顾性分析我院2021年1月至2022年5月收治的77例行MoLEP治疗的BPH合并AUR的患者。按照患者术前是否处于尿管留置状态将患者分为A、B两个亚组。比较A、B两组之间的术前基线资料、围手术期资料和术后3个月内随访数据之间的差异。结果A、B两组患者术后Qmax[19.60mL/s(11.30,23.38)vs 18.00mL/s(11.90,25.00),P=0.786]、PVR[11.00mL(0.00,23.25)vs 6.00mL(0.00,20.00),P=0.498]、IPSS评分[5.50分(3.00,8.25)vs 3.00分(2.00,8.00),P=0.271]、QOL评分[1.00分(1.00,5.00)vs 2.00分(1.00,6.00),P=0.174]及并发症发生比例无显著差异。A组患者术后IPSS评分[3.00分(2.00,8.00)vs 20.00分(16.00,25.00),P<0.001]和QOL评分[1.00分(1.00,5.00)vs 5.00分(4.00,5.00),P<0.001]较术前均显著降低。B组患者术后IPSS评分[5.50分(3.00,8.25)vs 21.00分(17.00,25.00),P<0.001]和QOL评分[2.00分(1.00,6.00)vs 4.00分(4.00,5.00),P<0.032]也较术前显著降低。结论MoLEP可以安全有效地解除BPH伴AUR患者下尿路梗阻,进而明显改善患者下尿路症状并有效提升患者生活质量。术前尿管留置状态对BPH伴AUR患者手术短期预后无显著影响。Objective To evaluate the effectiveness and safety of moses technology holmium laser enucleation of the prostate(MoLEP)for patients with benign prostatic hyperplasia(BPH)accompanied by acute urinary retention(AUR),and to investigate whether the status of urinary catheter indwelling will affect the short-term outcomes of BPH treated with MoLEP.Methods We retrospectively analyzed 77 BPH patients with AUR who were treated with MoLEP in our hospital from January,2021 to May,2022.Patients were divided into two subgroups A and B according to whether they had indwelled catheter before surgery.The basic information,perioperative data,and follow-up data at 3 months postoperatively between group A and group B were compared and evaluated.Results There was no significant difference in Qmax[19.60 mL/s(11.30,23.38)vs 18.00 mL/s(11.90,25.00),P=0.786],PVR[11.00 mL(0.00,23.25)vs 6.00 mL(0.00,20.00),P=0.498],IPSS[5.50(3.00,8.25)vs 3.00(2.00,8.00),P=0.271],QOL[1.00(1.00,5.00)vs 2.00(1.00,6.00),P=0.174]and the incidence of postoperative complications between group A and B.The postoperative IPSS score[3.00(2.00,8.00)vs 20.00(16.00,25.00),P<0.001]and QOL score[1.00(1.00,5.00)vs 5.00(4.00,5.00),P<0.001]of group A were significantly lower than those before surgery.The postoperative IPSS score[5.50(3.00,8.25)vs 21.00(17.00,25.00),P<0.001]and QOL score[2.00(1.00,6.00)vs 4.00(4.00,5.00),P<0.032]of group B were also significantly lower than those before surgery.Conclusion MoLEP can safely and effectively relieve lower urinary tract obstruction in patients with BPH accompanied by AUR,thereby significantly improve lower urinary tract symptoms and the quality of life of patients.Preoperative urinary catheter indwelling status has no significant effect on the short-term surgical prognosis of BPH patients with AUR.

关 键 词：良性前列腺增生 急性尿潴留 摩西钬激光前列腺剜除术 留置尿管 

分 类 号：R697.32[医药卫生—泌尿科学]