[1]覃斌* 覃鹤林 吴清国 梁毅文 黄寿付 季汉初 李长赞 梁阳冰.经尿道前列腺钬激光剜除术与经尿道前列腺电切术治疗良性前列腺增生的疗效比较[J].中国微创外科杂志,2022,01(1):48-54.
　Qin Bin,Qin Helin,Wu Qingguo,et al.Comparison of Curative Effect of Holmium Laser Enucleation of the Prostate and Transurethral Resection of Prostate for Benign Prostatic Hyperplasia[J].Chinese Journal of Minimally Invasive Surgery,2022,01(1):48-54.
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经尿道前列腺钬激光剜除术与经尿道前列腺电切术治疗良性前列腺增生的疗效比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年1期
页码:
48-54
栏目:
临床研究
出版日期:
2022-04-07

文章信息/Info

Title:
Comparison of Curative Effect of Holmium Laser Enucleation of the Prostate and Transurethral Resection of Prostate for Benign Prostatic Hyperplasia
作者:
覃斌* 覃鹤林 吴清国 梁毅文 黄寿付 季汉初 李长赞 梁阳冰
(广西医科大学第八附属医院贵港市人民医院泌尿外科，贵港537100)
Author(s):
Qin Bin;  Qin Helin;  Wu Qingguo;  et al.
Department of Urology, Eighth Affiliated Hospital of Guangxi Medical University, People’s Hospital of Guiguang, Guigang 537100, China
关键词:
前列腺钬激光剜除术; 经尿道前列腺电切术; 钬激光; 良性前列腺增生
Keywords:
Holmium laser enucleation of the prostate; Transurethral resection of prostate; Holmium laser; Benign prostatic hyperplasia
文献标志码:
A
摘要:
目的探讨经尿道前列腺钬激光剜除术(homium laser enucleation of the prostate，HOLEP)和经尿道前列腺电切术(transurethrue resection of prostate，TURP)治疗良性前列腺增生(benign prostatic hyperplasia, BPH)的临床效果。方法选取2017年11月～2019年7月我院HOLEP或TURP治疗良性前列腺增生143例，根据病人经济情况选择术式，HOLEP组75例，TURP组68例。比较2组前列腺标本重量、血红蛋白下降幅度、手术时间、术后住院时间、术后导尿管留置时间、膀胱冲洗时间、术后最大尿流率(Qmax)、膀胱残余尿量(residual urine volume，RUV)、国际前列腺症状评分(International Prostate Symptom Score, IPSS)、生活质量(Quality of Life，QOL)评分以及并发症情况。结果2组手术时间比较差异无统计学意义［(68.3±10.4)min vs.(71.2±10.3)min,t=-1.675,P=0.096］。HOLEP组血红蛋白下降幅度中位数明显小于TURP组［2(0～10)g/L vs.7(0～10)g/L,Z=-7.244,P=0.000］，前列腺标本重量明显大于TURP组［(59.3±18.5)g vs.(50.7±141)g,t=3.109,P=0.002］，膀胱冲洗时间明显短于TURP组［(15.8±6.9)h vs.(44.0±13.3)h，t=-16.135，P=0.000］，术后导尿管留置时间明显短于TURP组［(1.1±0.5)d vs.(4.3±1.0)d,t=-23.624,P=0.000］，术后住院时间明显短于TURP组［(1.6±0.5)d vs.(4.7±1.3)d,t=-18.891,P=0.000］。2组并发症比较差异无统计学意义(χ2=0.270，P=0603)。术后第1、3个月进行尿动力学检查，2组QOL评分、Qmax比较差异有显著性(均P=0.000)，IPSS评分、RUV比较差异无显著性(P＞0.05)；2组IPSS评分、Qmax组间和时间有交互作用(P＜0.05)，QOL评分、RUV组间和时间无交互作用(P＞0.05)。结论HOLEP治疗BPH出血少，剜除前列腺彻底，缩短膀胱冲洗、术后导尿管留置及住院时间，可作为日间手术，适用于放置心脏支架、长期服用抗凝药的患者，能提高患者的生活质量，临床效果好，安全性高。
Abstract:
ObjectiveTo investigate the clinical efficacy and safety of transurethral holmium laser enucleation of the prostate (HOLEP) and transurethrue resection of prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH).MethodsA total of 143 cases with BPH who received HOLEP or TURP in our hospital from November 2017 to July 2019 were selected. The operative methods were selected according to their economic conditions, including 75 cases in the HOLEP group and 68 cases in the TURP group. The weight of prostate specimen, decrease of hemoglobin, operative time, length of postoperative hospital stay, postoperative catheter indwelling time, bladder irrigation time, postoperative maximum urinary flow rate (Qmax), residual urine volume (RUV), international prostate symptom score (IPSS), quality of life index (QOL) and complications were compared between the two groups.ResultsThere was no significant difference in the operative time between the two groups ［(683±10.4) min vs. (71.2±10.3) min, t=-1.675, P=0.096］. The decrease of hemoglobin in the HOLEP group was significantly lower than that in the TURP group ［2 (0-10) g/l vs. 7 (0-10) g/l, Z=-7.244, P=0.000］. The weight of prostate specimens in the HOLEP group was significantly higher than that in the TURP group ［(59.3±18.5) g vs. (50.7±14.1) g, t=3.109, P=0.002］. The bladder irrigation time in the HOLEP group was significantly shorter than that in the TURP group ［(158±6.9) h vs. (44.0±13.3) h, t=-16.135, P=0.000］. The duration of postoperative catheter indwelling in the HOLEP group was significantly shorter than that in the TURP group ［(1.1±0.5) d vs.(4.3±1.0) d, t=-23.624, P=0.000］. The length of postoperative hospital stay in the HOLEP group was significantly shorter than that in the TURP group ［(1.6±0.5) d vs.(47±1.3) d, t=-18.891, P=0.000］. There was no statistically difference in complications between the two groups (χ2=0.270, P=0.603).Urodynamic examination was performed at 1 and 3 months after surgery. There were significant differences in the QOL score and Qmax between the two groups (both P=0.000), but no significant differences in IPSS score and RUV between the two groups (both P>0.05). The IPSS score and Qmax had interactions between groups and time ( both P＜0.05), while the QOL score and RUV had no interactions between groups and time (both P>0.05). ConclusionsIn the treatment of BPH, HOLEP has less bleeding, more complete prostate enucleation, and shorter bladder irrigation, catheter indwelling and hospitalization time. It can be used as a day surgery, and suitable for patients with stent placement and longterm use of anticoagulant drugs, which can improve the quality of life of patients with good clinical effect and high safety.

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备注/Memo

备注/Memo:
*通讯作者，Email:qbin081@126.com
更新日期/Last Update: 2022-04-07