HoLEP与TURP治疗良性前列腺增生的疗效及安全性观察

The efficacy and safety of HoLEP and TURP in the treatment of patients with benign prostatic hyperplasia

目的 分析对比前列腺激光剜除术（HoLEP）和前列腺电切术（TURP）治疗良性前列腺增生的近期疗效.方法 将2011年1月至2014年12月120例在本院接受手术治疗的前列腺增生的患者随机分为2组：A组和B组.其中A组患者行HoLEP手术,B组患者接受TURP手术治疗.同时记录两组患者在围手术期和手术后1、6、12个月后复查的指标结果.比较患者的生活质量评分（QOL）、最大尿流率（Qmax）以及国际前列腺症状评分（IPSS）等指标的变化.此外将两种手术方法的疗效也进行比较.结果 手术前A、B两组患者的生活质量评分、最大尿流率、国际前列腺症状评分、前列腺重量和残余尿量的比较均无统计学意义（t=-0.665、-0.441、0.639、-0.758、-0.778,P=0.508、0.660、0.524、0.450、0.438）;A组患者在手术中的平均出血量是（78.25±25.78）mL,低钠血症的平均发生率是5％,膀胱留管时间和冲洗时间分别为（2.37±1.35）d、（1.25±0.49）d,而B组分别是（136.78±29.45） mL、25％、（5.34±2.02）d、（2.54±0.78）d,各项指标明显比A组患者较高,且差异具有统计学差异（t或x2=-9.713、6.000、-8.130、-9.361,P＜0.05）;同时,患者手术1个月、6个月和12个月后,A、B两组患者的生活质量评分、最大尿流率、国际前列腺症状评分比手术前均有改善,且相同时间两组的患者各项指标的比较均显示A组的患者优于B组的患者,差异具有统计学意义（P＜0.05）.结论 HoLEP治疗良性前列腺增生的近期疗效优于TURP手术方法,并且在手术过程中安全性高,是治疗良性前列腺增生的一种较好的方法.

Objectives To analyze the short-term effects of holmium laser enucleation of the prostate（HoLEP） and transurethral resection of the prostate（TURP） in the treatment of benign prostatic hyperplasia.Methods 120 patients with prostatic hyperplasia in our hospital were randomly divided into 2 groups from January 2011 to December 2014.The patients in group A underwent HoLEP,while the group B underwent TURP.Quality of life score （QOL）,maximum urinary flow rate （Qmax）,the international prostate symptom score （IPSS） and efficacy of two groups were recorded and compared between perioperative period and 1,6,12 months after operation.Results There were no statistically significance in quality of life scores,maximum urinary flow rate,the international prostate symptom score,the prostate weight and residual urine volume between the two groups before operation （t =0.665,0.441,0.639,0.758,0.778,P =0.508,0.660,0.524,0.660,0.524）.The bleeding in the surgery,the average incidence of hyponatremia,the bladder indwelling catheter and washing time was（78.25 ±25.78）mL,5%,（2.37 ± 1.35）d,（1.25±0.49）din group A,respectively.And the group B was（136.78 ± 29.45） mL,25%,（5.34 ± 2.02） d,（2.54 ± 0.78） d,respectively.Group B was significantly higher than group A（P 〈 0.05）.At the same time,quality of life scores,maximum urinary flow rate,the international prostate symptom score 1,6,12 months after operation were improved than before treatment,and the indicators in group A were improved than group B（P 〈 0.05）.Conclusions The efficacy and safety of HoLEP in the treatment of patients with benign prostatic hyperplasia are better than that of TURP.It is a good treatment for benign prostatic hyperplasia.