三种经尿道前列腺手术对前列腺增生患者近期疗效的比较分析

Comparative analysis of short-term curative effect of HoLEP, TURP and PKEP for patients with benign prostatic hyperplasia

目的:探讨经尿道前列腺钬激光剜除术(HoLEP)与经尿道前列腺电切术(TURP)和经尿道双极等离子前列腺剜除术(PKEP)对良性前列腺增生(BPH)患者治疗效果上的差异.方法:选取2017年7月-2019年6月就诊的150例患者,按手术方式均分为三组:HoLEP组、TURP组及PKEP组.比较各组患者术前、围术期及术后随访期(1、3、6个月)的膀胱剩余尿量(PVR)、最大尿流率(Qmax)、国际前列腺症状评分表(IPSS)、生活质量评分(QOL)等指标.结果:三组患者术前基线资料差异无统计学意义(P>0.05).三组患者平均住院日、术后Qmax、PVR、IPSS评分和QOL评分均较术前有显著改善(P<0.05),其中HoLEP组术后改善幅度最大.且与TURP及PKEP相比,HoLEP组术后的血红蛋白量及血清钠水平没有明显降低(P>0.05).结论:HoLEP治疗BPH术后膀胱冲洗时间、尿管留置时间及平均住院日均较TURP及PKEP短,具有更好的近期疗效.

Objective:To investigate the difference in the treatment efficacy of transurethral holmium laser enucleation of prostate(HoLEP),transurethral resection of prostate(TURP)and transurethral bipolar plasma enucleation of prostate(PKEP)for patients with benign prostatic hyperplasia(BPH).Methods:A total of 150 patients in our hospital from July 2017 to June 2019 were selected and randomly divided into three groups,including HoLEP group,TURP group and PKEP group,with 50 cases in each group.We compared the indicators of the three groups of patients before surgery,perioperation and postoperative follow-up(1 month,3 months and 6 months),such as bladder residual urine volume(PVR),maximum urine flow rate(Qmax),International Prostate Symptom Score(IPSS),Quality of Life Score(QOL).Results:There was no statistically significant difference in the preoperative characteristics among the HoLEP group,TURP group and PKEP group(P>0.05).Compared with preoperation,the indicators of the three groups,such as average hospital stay,weight of prostate removed,Qmax,PVR,IPSS score and QOL score,were significantly improved after the operation(P<0.05),and the HoLEP group had the largest improvement after surgery.Moreover,postoperative serum hemoglobin and sodium levels in HoLEP group did not significantly decrease as compared with TURP and PKEP.Conclusion:The present study verified the better shortterm efficacy of HoLEP in treating patients with BPH,as HoLEP had shorter bladder irrigation and catheterization time and hospital stay than TURP and PKEP.