不同激光参数的钬激光前列腺剜除术治疗良性前列腺增生效果比较  

Comparison of the effects of holmium laser enucleation of the prostate with different laser parameters on patients with benign prostatic hyperplasia

作　　者：侯继开 王欢 吴小非 宋祥伟[1] HOU Jikai;WANG Huan;WU Xiaofei;SONG Xiangwei(Department of Urology,The First Hospital of Qiqihar,Qiqihar,Heilongjiang 161000,China)

机构地区：[1]齐齐哈尔市第一医院泌尿外科,黑龙江齐齐哈尔161000

出　　处：《中国临床研究》2025年第2期285-288,共4页Chinese Journal of Clinical Research

摘　　要：目的比较不同激光参数的钬激光前列腺剜除术(HoLEP)对良性前列腺增生(BPH)患者的影响。方法回顾性分析2021年6月至2023年6月在齐齐哈尔市第一医院住院行HoLEP的BPH患者110例的临床资料,根据钬激光参数的不同将患者分为A组(37例)、B组(37例)、C组(36例)。A组行45 W(1.5 J×30 Hz)HoLEP;B组行60 W(2.0 J×30 Hz)HoLEP;C组行80 W(2.0 J×40 Hz)HoLEP。比较各组手术相关指标及术后并发症情况;比较手术前及术后3个月的国际前列腺症状(IPSS)评分、生活质量(QOL)评分、最大尿流率(Qmax)、膀胱残余尿量(PVR)改善情况。结果3组手术相关指标比较差异无统计学意义(P>0.05)。术后3个月,3组IPSS评分、QOL评分、PVR均低于术前,Qmax高于术前(P<0.05);3组间IPSS评分、QOL评分、PVR、Qmax比较差异无统计学意义(P>0.05)。3组并发症发生率比较差异无统计学意义(P>0.05)。结论45、60 W的低功率HoLEP与80 W高功率的HoLEP疗效相当,在手术时间、住院时间、导尿管留置时间及剜除前列腺质量、剜除效率无差异,且均有良好的止血效果和安全性。临床应根据不同功率钬激光的特点进行选择,最大程度地发挥钬激光的优势。Objective To compare the effects of holmium laser enucleation of the prostate(HoLEP)with different laser parameters on patients with benign prostatic hyperplasia(BPH).Methods The clinical data of 110 patients with BPH who underwent HoLEP in the First Hospital of Qiqihar from June 2021 to June 2023 were retrospectively analyzed.Patients were divided into group A(37 cases),group B(37 cases)and group C(36 cases)according to the parameters of Holmium laser.Group A underwent 45 W(1.5 J×30 Hz)HoLEP;in group B,60 W(2.0 J×30 Hz)HoLEP was performed.Group C was treated with 80 W(2.0 J×40 Hz)HoLEP.The operation-related indexes and postoperative complications of each group were compared.The improvement of international prostate symptom score(IPSS),quality of life(QOL),maximum urine flow rate(Qmax)and postoperative residual urine volume(PVR)were compared before and 3 months after operation.Results There was no significant difference in operation-related indexes among groups A,B and C(P>0.05).IPSS score,QOL score and PVR of patients in group A,B and C 3 months after operation were lower than those before operation,and Qmax was higher than that before operation(P<0.05).While 3 months after operation,there was no significant difference in IPSS score,QOL score,PVR and Qmax among group A,B and C(P>0.05).There was no significant difference in the incidence of complications among the three groups(P>0.05).Conclusion 45 W,60 W low-power HoLEP is equivalent to 80 W high-power HoLEP,and there is no significant difference in operation time,hospital stay,indwelling time of catheter,enucleation quality and enucleation efficiency,and both have good hemostasis effect and safety.

关 键 词：良性前列腺增生 钬激光前列腺剜除术 激光参数 国际前列腺症状评分 生活质量 

分 类 号：R697.3[医药卫生—泌尿科学] R699[医药卫生—外科学]