小功率钬激光前列腺剜除术治疗良性前列腺增生的效果评价

Effect assessment of low power holmium laser enucleation of the prostate for benign prostatic hyperplasia

目的:评价小功率(60W)钬激光前列腺剜除术(HoLEP)治疗良性前列腺增生(BPH)的可行性、安全性及疗效。方法:将我院于2010年1月~2012年7月收治的240例BPH患者随机分成两组,每组120例,分别施行小功率HoLEP(A组)及TURP(B组)。A组平均年龄(68.2±10.2)岁,平均前列腺体积(62.5±8.9)ml;42例合并慢性基础性疾病。B组平均年龄(67.7+12.2)岁,平均前列腺体积(65.3±9.1)ml;39例合并慢性基础疾病。比较两组手术时间,切除标本重量,术后半小时血清Na+,术后2小时血Hb,并发症发生率,术后冲洗、留置尿管及住院时间,术后3个月、6个月、1年Q_(max)、IPSS、QOL、PSA。结果:两组手术均成功完成。两组患者年龄、术前前列腺体积、Q_(max)、RUV、IPSS、QOL、血清Na^+浓度及血Hb比较差异均无统计学意义(P>0.05)。A组切除标本重量、术后半小时血清Na^+、术后2小时血Hb、并发症发生率、术后冲洗、术后留置尿管及术后住院时间与B组比较,差异均有统计学意义(P<0.05);而两组手术时间、术后3个月、6个月、1年Q_(max)、IPSS、QOL、PSA比较,差异均无统计学意义(P>0.05)。结论:小功率HoLEP微创治疗BPH安全、有效,与TURP疗效相当,且降低了相关手术风险,并发症发生率低,值得临床应用。

Objective：To evaluate the feasibility,safety and efficacy of low power holmium laser enucleation of prostate（HoLEP）for treatment of BPH.Method：From January 2010 to July 2012,a total of 240 patients with BPH were randomly divided into two groups.Patients of group A（120cases）were received low power HoLEP and other 120cases（group B）were received transurethral resection of the prostate（TURP）.The average age of patients of group A was（68.2±10.2）years old,and mean prostate volume was（62.5±8.9）ml.Forty-two of them were also diagnosed with other chronic basic diseases.The average age of patients of group B was（67.7 ＋12.2）years old,and mean prostate volume was（65.3 ± 9.1）ml.Thirty-nine of them were also diagnosed with other chronic basic diseases.The operative time,resected specimen weight,serum Na＋at postoperative half an hour,the hemoglobin at postoperative two hours,complications,catheter washing time,indwelling catheter time and postoperative hospital time,Q max,IPSS,QOL,PSA at postoperative three months,six months and one year were compared respectively between two groups.Result：Both low power HoLEP and TURP were performed successfully on 240 cases.The difference in the age,preoperative prostate volume,Qmax,PVR,IPSS,QOL,serum Na＋and hemoglobin between the two groups were not statistically significant（P〈0.05）.The difference of the specimen weight,serum Na＋at postoperative half an hour,hemoglobin at postoperative two hours,complications,catheter washing time,indwelling catheter time and postoperative hospital time between the two groups were statistically significant（P〈0.05）.However,the difference of operation time,Qmax,IPSS,QOL and PSA level at postoperative three months,six months and one year between the two groups were not statistically significant（P〈0.05）.Conclusion：Low power HoLEP is as feasible,safe,and effective as TURP.Low power HoLEP is worthy of clinical application for its low surgical risk and low incidence of complications.