钬激光前列腺剜除术与经尿道前列腺电切术的疗效

Outcomes of transurethral resection of benign prostatic hyperplasia by HoLEP and TURP

目的比较钬激光前列腺剜除术(HoLEP)与经尿道前列腺电切术(TURP)的临床疗效。方法良性前列腺增生症(BPH)而导致膀胱出口梗阻的患者100例随机分为两组,分别采用HoLEP(HoLEP组,45例)和TURP(TURP组,55例)。比较两组围手术期相关指标。结果术后3个月,两组国际前列腺症状评分、生活质量评分、最大尿流率、残余尿量均比术前改善(P<0.01),但组间比较无统计学差异(P>0.05)。HoLEP组术中出血量少于TURP组[(67.4±8.6)ml vs.(196.2±28.3)ml](P<0.05)。HoLEP组手术时间长于TURP组(P<0.01),切除的前列腺重量少于TURP组(P<0.05)。HoLEP组术后膀胱冲洗时间、置管时间和术后住院时间短于TURP组(P<0.05)。结论两种术式治疗BPH的短期疗效相当;但与TURP比较,HoLEP更符合前列腺病理生理改变,术中出血少,残留腺体少。

Objective To compare the outcomes of transurethral resection of benign prostatic hyperplasia（BPH） by holmium laser enucleation of prostate（HoLEP） and transurethral resection of prostate（TURP）. Methods A total of 100 patients with BPH was assigned into two groups of A （treated with HoLEP, 45 cases） and B（treated with TURP, 55 cases）. Perioperative data were compared between two groups. Results The quality of life score（QOL） ,maximum urinary flow rate （Qmax） and residual urine volume（PVR） were significantly improved three months after operation compared to before in two groups （P〈0. 01）, which were not significantly different between two groups（P〈0. 05）. The blood loss in operation was less in group A than that in group B[（67. 4±8. 6） ml vs. （196.2±28. 3） ml]（P〈0. 05）. The operative time was longer in group A than that in group B （P〈0.01）. The weight of resected prostate tissues was less in group A than that in group B （P〈0. 05）. The time of bladder irrigation, catheter indwelling time and hospital stay were shorter in group A than those in group B（P〈0. 05）. Conclusion HoLEP and TURP have a similar short-term efficacy in the treatment of BPH. HoLEP is more in accordance with pathophysiological changes of the prostate, with less surgical blood loss and less residual prostate tissues than TURP.