经尿道前列腺铥激光剜除术与经尿道前列腺电切术术后膀胱痉挛发生情况对比研究  

A Comparative Study on the Incidence of Postoperative Bladder Spasms Following Transurethral Prostate Thulium Laser Resection and Transurethral Prostate Resection

作　　者：刘晓宇 李凯 李瑞[1] 张艳涛 梅延辉[1] Liu Xiaoyu;Li Kai;Li Rui;Zhang Yantao;Mei Yanhui(Department of Urology,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院泌尿外科,滨州256603

出　　处：《微创泌尿外科杂志》2025年第1期20-24,共5页Journal of Minimally Invasive Urology

摘　　要：目的:探讨经尿道前列腺铥激光剜除术(ThuLEP)与经尿道前列腺电切术(TURP)术后膀胱痉挛发生情况。方法:回顾性分析滨州医学院附属医院2023年1月至2024年1月行微创手术治疗的296例良性前列腺增生患者的临床资料。ThuLEP组162例,TURP组134例,两组患者的年龄[(68.79±6.33)岁vs.(67.98±6.55)岁,P=0.280]、体质量指数(BMI)[(25.26±4.82)kg/m^(2)vs.(24.87±4.92)kg/m^(2),P=0.489]、前列腺体积[(75.45±11.54)ml vs.(74.39±11.66)ml,P=0.433]比较差异均无统计学意义。比较两组患者术后膀胱痉挛发生频次、单次膀胱痉挛最长持续时间、膀胱痉挛的严重程度、留置导尿管堵塞的次数及术后膀胱痉挛需要临床干预的次数;并比较两组患者手术学相关指标。结果:所有手术均顺利完成。ThuLEP组与TURP组的膀胱痉挛发生频次[(2.64±0.69)次vs.(5.39±1.24)次]、单次膀胱痉挛最长持续时间[(7.88±1.69)min vs.(19.23±5.97)min]、膀胱痉挛的最高视觉模拟评分法(VAS)评分[(2.89±0.85)分vs.(7.04±1.25)分]、留置导尿管堵塞的次数[1(0,2)次vs.1(1,2)次]、术后膀胱痉挛需要临床干预的次数[2(0,2)次vs.5(4,6)次]比较差异均有统计学意义(P均<0.01)。ThuLEP组和TURP组的总手术时间[(62.24±12.36)min vs.(90.23±16.23)min]、术中出血量[(63.28±12.73)ml vs.(97.38±22.31)ml]、留置导尿管时间[(3.87±0.77)d vs.(5.85±1.57)d]、膀胱冲洗时间[(20.36±4.22)h vs.(48.36±8.59)h]比较差异均有统计学意义(P均<0.01)。结论:相比TURP,ThuLEP能显著降低术后膀胱痉挛的发生频次、持续时间、严重程度,考虑与ThuLEP较优的手术学指标有关。Objective:To compare the incidence of postoperative bladder spasms following Transurethral Pros-tate Thulium Laser Enucleation(ThuLEP)and Transurethral Resection of the Prostate(TURP).Methods:A retro-spective analysis was conducted on 296 patients with benign prostatic hyperplasia who underwent minimally invasive surgery at the Affiliated Hospital of Binzhou Medical University between January 2023 and January 2024.There were 162 patients in the ThuLEP group and 134 in the TURP group.The age[(68.79±6.33)years vs.(67.98±6.55)years,P=0.280],body mass index(BMI)[(25.26±4.82)kg/m^(2) vs.(24.87±4.92)kg/m^(2),P=0.489],and prostate volume[(75.45±11.54)ml vs.(74.39±11.66)ml,P=0.433]did not differ significantly between the two groups.Postoperative bladder spasm frequency,the longest duration of a single spasm,spasm severity,catheter blockage events,and the need for clinical intervention for bladder spasms were compared between the two groups.Surgical pa-rameters were also analyzed.i Results:All surgeries were successfully completed.The frequency of bladder spasms[(2.64±0.69)vs.(5.39±1.24)],the longest duration of a single spasm[(7.88±1.69)in vs.(19.23±5.97)in],the highest visual analogue scale(VAS)score for bladder spasms[(2.89±0.85)vs.(7.04±1.25)],catheter blockage events[1(0,2)vs.1(1,2)],and the frequency of clinical intervention for bladder spasms[2(0,2)vs.5(4,6)]all showed significant differences (P<0.01).The total surgical time[(62.24±12.36)min vs.(90.23±16.23)min],intra-operative blood loss[(63.28±12.73)ml vs.(97.38±22.31)ml],catheterization duration[(3.87±0.77)days vs.(5.85±1.57)days],and bladder irrigation time[(20.36±4.22)hours vs.(48.36±8.59)hours]also showed signifi-cant differences(P<0.01).Conclusion:ThuLEP significantly reduces the frequency,duration,and severity of post-operative bladder spasms compared to TURP,likely due to the superior surgical outcomes associated with ThuLEP.

关 键 词：前列腺增生 膀胱痉挛 铥激光 前列腺剜除 经尿道前列腺电切术 

分 类 号：R697.3[医药卫生—泌尿科学]