经尿道前列腺等离子剜除术与钬激光剜除术治疗巨大前列腺增生的临床疗效比较  

Comparison of clinical efficacy between transurethral plasma enucleation of the prostate and holmium laser enucleation for the treatment of giant prostatic hyperplasia

作　　者：钱炜[1] 蒋堃[1] 王龙信 胡海斌 郑奇传[1] 朱清毅 魏勇 QIAN Wei;JIANG Kun;WANG Longxin;HU Haibin;ZHENG Qichuan;ZHU Qingyi;WEI Yong(Department of Urology,Ma'anshan People's Hospital,Ma'anshan,Anhui,243011,China;Department of Urology,the Second Affiliated Hospital of Nanjing Medical University)

机构地区：[1]马鞍山市人民医院泌尿外科,安徽马鞍山243011 [2]南京医科大学第二附属医院泌尿外科

出　　处：《临床泌尿外科杂志》2023年第7期510-513,共4页Journal of Clinical Urology

摘　　要：目的:对比经尿道前列腺等离子剜除术与钬激光剜除术治疗巨大前列腺增生的临床疗效。方法:选择2021年8月—2022年12月马鞍山市人民医院和南京医科大学第二附属医院270例巨大前列腺增生患者进行本次研究,按照随机数表法分为研究组(132例)和对照组(138例),对照组采用经尿道前列腺等离子剜除术治疗,研究组采用钬激光剜除术治疗。比较2组围术期指标,最大尿流率(Q_(max))、前列腺特异性抗原(PSA),生活质量(QOL)评分、国际前列腺症状评分(IPSS)、国际勃起功能指数-5(IIEF-5)评分,不良反应发生率。结果:研究组留置导尿管时间、血红蛋白(Hb)、手术时间、膀胱冲洗时间、住院时间均显著低于对照组[(2.86±0.69) d vs (7.90±1.32) d,(9.79±1.08) g/L vs (15.86±3.20) g/L,(89.27±19.36) min vs (118.37±26.58) min,(1.28±0.32) d vs (3.97±0.50) d,(5.19±0.51) d vs (9.29±1.38) d],差异均有统计学意义(P<0.05)。研究组Q_(max)显著高于对照组[(17.03±3.27) mL/s vs (12.39±2.08) mL/s];研究组QOL、IPSS评分显著低于对照组[(1.51±0.62)分vs (2.68±0.73)分,(9.21±0.80)分vs (15.90±0.96)分],IIEF-5评分显著低于对照组[(21.70±0.92)分vs (17.62±0.80)分],研究组不良反应发生率显著低于对照组[9.09%(12/132) vs 16.67%(23/138)],差异均有统计学意义(P<0.05)。结论:经尿道前列腺等离子剜除术与钬激光剜除术在治疗巨大前列腺增生均具有一定的治疗效果,但钬激光剜除术可缩短手术时间,减少出血,提高尿道通畅,改善勃起功能,不良反应少,安全有效。Objective To compare the clinical efficacy between transurethral plasma enucleation of the prostate and holmium laser enucleation for the treatment of giant prostatic hyperplasia.Methods From August 2021 to December 2022,270 patients with giant prostatic hyperplasia who received treatment in Ma'anshan People's Hospital and The Second Affiliated Hospital of Nanjing Medical University were selected for this study,and they were divided into study group(n=132)and control group(n=138)according to random number table method.The control group was treated with transurethral plasma enucleation of the prostate,while the study group used holmium laser enucleation surgery for treatment.The perioperative indicators,maximum urinary flow rate,prostate specific antigen,QOL,IPSS,IIEF-5 scores,and incidence of adverse reactions were compared between two groups.Results The retention time of catheter,Hb,operation time,bladder flushing time and hospital stay in the study group were significantly lower than those in the control group([2.86±0.69]d vs[7.90±1.32]d,[9.79±1.08]g/L vs[15.86±3.20]g/L,[89.27±19.36]min vs[118.37±26.58]min,[1.28±0.32]d vs[3.97±0.50]d,[5.19±0.51]d vs[9.29±1.38]d,P<0.05).The Q_(max) of the study group was significantly higher than that of the control group([17.03±3.27]mL/s vs[12.39±2.08]mL/s,P<0.05).The QOL and IPSS scores of the study group were significantly lower than those of the control group([1.51±0.62]scores vs[2.68±0.73]scores,[9.21±0.80]scores vs[15.90±0.96]scores,P<0.05).The IIEF-5 score was significantly lower than the control group([21.70±0.92]scores vs[17.62±0.80]scores,P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group(9.09%[12/132]vs 16.67%[23/138],P<0.05).Conclusion Both transurethral plasma enucleation of the prostate and holmium laser enucleation have certain therapeutic effects on the treatment of giant prostatic hyperplasia.However,holmium laser enucleation is safe and effective for it can shorten the surgical

关 键 词：经尿道前列腺等离子剜除术 钬激光剜除术 巨大前列腺增生 

分 类 号：R697[医药卫生—泌尿科学]