两种经尿道前列腺切除术的疗效比较

Curative effect of BPH:comparison between holmium laser enucleation of the prostate and transurethral resection of the prostate

目的比较经尿道钬激光前列腺剜除术和经尿道前列腺电切术治疗良性前列腺增生症的效果。方法前列腺增生症患者123例随机分为两组(剜除术组60例、电切术组63例),分别行HoLEP和TURP,监测、记录两组患者术前、术中及术后的相关临床指标,进行分析、对比。结果术前两组一般情况比较差异无统计学意义(P>0.05)。剜除术组手术时间、术中冲洗液量较电切术组多,但术中出血量、术后出血量、膀胱冲洗时间、尿管留置时间均小于电切术组。术后随访1～6个月,两组IPSS、Qmax较术前均明显改善(P<0.01);剜除术组发生尿道狭窄3例,尿失禁1例,无阳痿发生;电切术组发生尿道狭窄5例、尿失禁2例、阳痿1例,两组间手术并发症发生率差异无统计学意义(P>0.05)。结论剜除术治疗前列腺增生症,效果可靠,与电切术相比,具有出血少,术后恢复快等优点,值得进一步推广应用。

Objective To compare the efficacy of holmium laser enucleation of the prostate （HoLEP） with transurethral resection of the prostate （TURP） for the treatment of benign prostatic hyperplasia（BPH）. Methods 123 cases of BPH were divided into two groups randomly, of them 60 cases underwent HoLEP and 63 cases, TURP. The significant markers and therapeutic results were recorded and analyzed. Result There was no significant difference between the two groups in some preoperative factors （P 〉0.05）. The time of operation and the volume of irrigating fluid during operation for TURP was less than that for HoLEP. Significant difference was found between the two groups （P 〈0.01） . However, the blood loss in operation,the blood loss after operation ,the time of bladder irrigating after operation,the time of catheterization was shorter than those in TURP group. Significant difference was found between the two groups in the above four markers（P 〈0.05） . All the cases were followed up for 1 to 6 months. IPSS, Qmax were improved significantly compared with that of preoperative （P 〈0.01） . There were 5 cases of urethral stricture and 2 cases of incontinence of urine and 1 cases of impotence in the TURP group. While 3 cases of urethral stricture and 1 cases of incontinence of urine and 0 cases of impotence were found in the HoLEP group. No significant difference was found between the two groups （P〉0.05）. Conclusion HoLEP is more effective than TURP, however, with less obtainment of adverse side effect and wider adaptation. It should be performed extensively.