经尿道钬激光前列腺剜除术在良性前列腺增生中的应用及对尿动力学、性功能、氧化应激的影响  

Application of holmium laser enucleation of the prostate in benign prostatic hyperplasia and its influence on urodynamics,sexual function and oxidative stress

作　　者：张蕊 王健 王艳华 张艳 吴建华 ZHANG Rui;WANG Jian;WANG Yanhua;ZHANG Yan;WU Jianhua(Department of Urology,Chengde Central Hospital,Chengde,Hebei 067000,China;Department of General Medicine,Chengde Central Hospital,Chengde,Hebei 067000,China)

机构地区：[1]承德市中心医院泌尿外科,河北承德067000 [2]承德市中心医院全科医疗,河北承德067000

出　　处：《安徽医药》2023年第9期1819-1823,I0001,共6页Anhui Medical and Pharmaceutical Journal

基　　金：承德市科技支撑项目(202006A021)。

摘　　要：目的探讨经尿道钬激光前列腺剜除术(HoLEP)在良性前列腺增生(BPH)中的应用及对尿动力学、性功能、氧化应激的影响。方法前瞻性选取2019年1月至2021年1月承德市中心医院126例BPH病人,以随机数字表法分为对照组和试验组,各63例。对照组行前列腺电切术(TURP),试验组行HoLEP。观察两组手术情况、并发症、性功能,比较手术前后氧化应激指标[红细胞免疫复合物花环率(RBC-ICR)、红细胞黏附肿瘤细胞花环率(TRR)]、尿动力学指标[膀胱内残余尿量(PVR)、最大尿流率(Qmax)、生活质量量表(QOL)、国际前列腺症状评分表(IPSS)]、超声参数[阻力指数、加速指数]。结果试验组手术时间、膀胱冲洗时间、导尿管留置时间短于对照组,术中出血量[(90.23±7.68)mL]小于对照组[(125.51±12.25)mL](P<0.05);术后3 d试验组血清RBC-ICR[(32.26±3.27)%]低于对照组[(36.11±3.19)%],TRR[(23.38±4.12)%]高于对照组[(17.35±2.06)%](P<0.05);术后6个月试验组IPSS评分、加速指数低于对照组,阻力指数(0.50±0.05)小于对照组(0.59±0.06),Qmax大于对照组(P<0.05);术后6个月两组QOL评分[(1.26±0.41)分比(1.32±0.37)分]、PVR比较差异无统计学意义(P>0.05);两组并发症及术后6个月阴茎勃起强度比较差异无统计学意义(P>0.05)。结论HoLEP可缩短BPH病人手术时间,减少术中出血量,改善尿动力学指标及超声参数,改善排尿症状,且对氧化应激影响较小。Objective To explore the application of holmium laser enucleation of the prostate(HoLEP)in benign prostatic hyperplasia(BPH)and its effect on urodynamics,sexual function,and oxidative stress.Methods A total of 126 patients with BPH admitted to Chengde Central Hospital from January 2019 to January 2021 were prospectively selected and assigned into control group and experiment group by randomized number table grouping,with 63 cases in each group.The control group underwent transurethral resection of the prostate(TURP),and the experiment group underwent HoLEP.We observed the operation conditions,complications,and sexual function of the two groups,and compared the oxidative stress indicators[red blood cell immune complex rosette rate(RBC-ICR),RBC adhesion tumor cell rosette rate(TRR)],urodynamic indicators[postvoid residual(PVR),maximum urinary flow rate(Qmax),quality of life(QOL),International Prostate Symptom Score(IPSS)],ultrasound parameters[resistance index(RI),acceleration index(AI)]before and after the operation.Results The operation time,bladder flushing time,and catheter indwelling time in the experiment group were shorter than those in the control group,and the intraoperative blood loss[(90.23±7.68)mL]was less than that of the control group[(125.51±12.25)mL](P<0.05).On the 3rd day after surgery,the serum RBC-ICR[(32.26±3.27)%]of the experiment group was lower than that of the control group[(36.11±3.19)%],and the TRR[(23.38±4.12)%]was higher than that of the control group[(17.35±2.06)%](P<0.05).Six months after surgery,the IPSS score and acceleration index of the experiment group were lower than those of the control group,while the resistance index was lower than that of the control group(0.50±0.05 vs.0.59±0.06),and the Qmax was higher than that of the control group(P<0.05);there were no statistically significant differences in QOL score(1.26±0.41 vs.1.32±0.37)and PVR between the two groups 6 months after surgery(P>0.05);there were no statistically significant differences in the complications and p

关 键 词：前列腺增生 经尿道钬激光前列腺剜除术 前列腺电切术 超声参数 氧化应激 

分 类 号：R699.8[医药卫生—泌尿科学]