450 nm蓝激光前列腺汽化术对前列腺增生患者的手术指标、尿动力学、性功能、炎性-应激反应的影响  

Effects of 450 nm blue laser vaporization of prostate on surgical indexes,urodynamics,sexual function and inflammatory stress response in patients with prostatic hyperplasia

作　　者：刘向宇 凡新伟 张静 Liu Xiang-yu;Fan Xin-wei;Zhang Jing(Department of Urology,Henan Tianyou Cancer Hospital of Integrated Traditional Chinese and Western Medicine,Zhengzhou 450000,China)

机构地区：[1]河南天佑中西医结合肿瘤医院泌尿外科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第12期2614-2616,2702,共4页

基　　金：河南省医学科技攻关联合共建项目(编号:LHGJ20211062);。

摘　　要：目的:探讨450 nm蓝激光前列腺汽化术对前列腺增生患者手术指标、尿动力学、性功能、炎性-应激反应的影响。方法:回顾性收集2022年5月至2024年5月我院收治的139例前列腺增生患者,根据手术方法不同分为激光汽化组(n=71)和电切组(n=68)。术后,比较两组手术指标;术前及术后7 d,酶联免疫法检测血清白细胞介素(Interleukin,IL)-4、IL-17,反相高效色谱法测定血清5-羟基色胺(5-hydroxytryptamine,5-HT);术前及术后1 m,采用腹部B超检测残余尿量、膀胱容量、膀胱顺应性,国际勃起功能指数(International index of erectile function-5,IIEF-5)评估性功能,统计逆行射精率;比较两组术后并发症状况。结果:激光汽化组手术时间、膀胱冲洗时间、导尿管滞留时间、住院时间均短于电切组,术中总出血量少于电切组(P<0.05);术后7 d,激光汽化组血清5-HT、IL-17水平低于电切组,IL-4水平高于电切组(P<0.05);术后1m,两组膀胱容量、膀胱顺应性均显著上升,残余尿量显著下降(P<0.05),但组间相比无显著差异(P>0.05);术后1m,激光汽化组IIEF-5评分高于电切组,逆行射精发生率低于电切组(P<0.05);激光汽化组术后并发症发生率低于电切组(P<0.05)。结论:450 nm蓝激光前列腺汽化术治疗前列腺增生患者能减轻机体炎性-应激反应,改善尿动力学指标和性功能,减少术中出血量,促进术后快速康复。Objective:To investigate the effects of 450 nm blue laser vaporization of prostate on surgical indexes,urodynamics,sexual function and inflammatory stress response in patients with prostate hyperplasia.Methods:A total of 139 patients with prostatic hyperplasia treated in our hospital from May 2022 to May 2024 were retrospectively collected and divided into laser vaporization group(n=71)and electric resection group(n=68)according to different surgical methods.After surgery,operative indexes were compared between the two group;before and after 7 days of surgery,interleukin(IL)-4,IL-17 were detected by enzyme-linked immunosorbent assay,5-hydroxytamine(5-HT)was detected by reversed phase high performance chromatography;before and after 1 month of surgery,residual urine volume,bladder volume,bladder compliance were detected by abdominal B-ultrasonography,sexual function was assessed by international index of erectile function-5(IIEF-5),retrograde ejaculation rate was measured;postoperative complications were compared between the two groups.Results:The operation time,bladder flushing time,catheter retention time and hospital stay in the laser vaporization group were shorter than those in the electric resection group,and the total intraoperative blood loss was less than that in the electric resection group(P<0.05).After 7 days of surgery,the levels of 5-HT and IL-17 in the laser vaporization group were lower than those in the electric resection group,and the level of IL-4 was higher than that in the electric resection group(P<0.05);after 1 month of surgery,bladder volume and bladder compliance were significantly increased,while residual urine volume was significantly decreased in both groups(P<0.05),but there was no significant difference between two groups(P>0.05).After 1 month of surgery,the IIEF-5 score in laser vaporization group was higher than that in electric resection group,and the incidence of retrograde ejaculation was lower than that in electric resection group(P<0.05).The incidence of postoperative complicat

关 键 词：前列腺增生 蓝激光汽化术 电切术 尿动力学 性功能 

分 类 号：R699.8[医药卫生—泌尿科学]