“U”形整叶法经尿道光纤铥激光前列腺剜除术在良性前列腺增生中的应用  

Application of transurethral thulium laser enucleation of the prostate with U-shaped whole leaf method in benign prostatic hyperplasia

作　　者：蓝旭华 李代畅 吴欣蔚 LAN Xuhua;LI Daichang;WU Xinwei(Wuyi County First People's Hospital,Zhejiang 321200,China)

机构地区：[1]浙江省武义县第一人民医院,武义321200

出　　处：《浙江创伤外科》2025年第3期406-409,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 探究“U”形整叶法经尿道光纤铥激光前列腺剜除术在良性前列腺增生(BPH)患者中的应用效果。方法 回顾性选取2021年5月至2024年5月本院收治的88例BPH患者作为研究对象,按照手术方式的不同分为整叶法组(n=43)及分叶法组(n=45),整叶法组行常规治疗联合“U”形整叶法TmLRP,分叶法组行常规治疗联合分叶法TmLRP。比较两组患者的手术相关指标情况、血流动力学、剜切情况、下尿路症状、并发症。结果 全程治疗后,整叶法组的手术时间、出血量及止血时间的数值均低于分叶法组(P<0.05);整叶法组剜切时间的数值低于分叶法组,剜切效率的数值高于分叶法组(P<0.05);而整叶法组治疗前的IPSS评分、Qmax、PVR、Hb、HCT水平相比分叶法组无明显优势,差异无统计学意义(P>0.05);整叶法组治疗后IPSS评分和PVR水平低于分叶法组,Qmax水平高于分叶法组(P<0.05);整叶法组患者的Hb和Hct数值低于分叶法组(P<0.05);最终整叶法组较分叶法组并发症发生率降低(P<0.05)。结论 “U”形整叶法TmLRP安全性较高,可改善BPH患者的临床症状,优化术后尿流动力学和血流动力学指标,降低不良并发症发生率,更有利于患者术后恢复。Objective This paper investigates the efficacy of the U-shaped rectification method of transurethral fiber-optic thulium laser prostatectomy(TmLRP) in patients with BPH.Methods 88 BPH patients admitted to our hospital from May 2021 to May 2024 were retrospectively selected as study subjects,and were divided into the whole lobe group(n=43) and the lobulated group(n=45) according to the different surgical methods.Patients in the whole lobe group were underwent conventional treatment combined with TmLRP of the U-shaped whole lobe method,and in the lobulated group underwent conventional treatment combined with TmLRP of the lobulated method.The surgical-related indexes,hemodynamics,enu-cleation,lower urinary tract symptoms and complications of the two groups were compared.Results After the full treatment,the values of operation time,bleeding volume and hemostasis time of the whole lobe method group were lower than those of the lobed method group( P<0.05).The values of enucleation time of the whole lobe method group were lower than those of the lobed method group,and the values of enucleation efficiency were higher than those of the lobed method group(P<0.05).Whereas,there was no significant advantage of the pre-treatment levels of IPSS score,Qmax,PVR,Hb,HCT in the whole lobe method group compared with those of the lobed method group(P>0.05).IPSS score and PVR levels were lower and Qmax levels were higher in the whole lobe method group than in the lobulated method group after treatment( P<0.05).Hb and Hct values of patients in the whole lobe method group were lower than in the lobulated method group(P<0.05).And ultimately,the rate of complications was reduced in the whole lobe method group compared with that in the lobulated method group(P<0.05).Conclusion The U-shaped rectification method of TmLRP is safer,improves the clinical symptoms of BPH patients,optimizes the postoperative urodynamic and hemodynamic indexes,reduces the incidence of adverse complications,and is more conducive to patients' postoperative recovery.

关 键 词：“U”形整叶法 光纤铥激光 前列腺剜除术 良性前列腺增生 分叶法 

分 类 号：R699.8[医药卫生—泌尿科学]