经尿道钬激光剜除术治疗良性前列腺增生的临床观察

Clinical observation of transurethral holmium laser enucleation in the treatment of benign prostatic hyperplasia

目的 对比经尿道钬激光剜除术与经尿道等离子切除术治疗良性前列腺增生的临床效果.方法 选择2013年1月至2014年12月在本院住院治疗的良性前列腺增生患者83例为研究对象,将患者随机分为钬激光组（42例）和等离子组（41例）,分别给予钬激光剜除术或等离子切除术治疗.比较两组患者治疗前后IPSS、术中出血量、手术时间、术后置管时间、住院时间、残余尿及并发症发生情况等.结果 钬激光组术中出血量、手术时间均少于等离子组;术后尿管留置时间及术后住院时间均短于等离子组（P＜0.05）.两组患者IPSS和残余尿量均显著下降（P＜0.05）.术前两组IPSS、残余尿量比较,差异无统计学意义;术后两组IPSS、残余尿量比较,差异亦无统计学意义（P＞0.05）.两组并发症发生率比较,差异无统计学意义（P＞0.05）.结论 钬激光或等离子切除术治疗良性前列腺增生均获具有良好的疗效和安全性,对于有前列腺电切术禁忌证的患者,可以考虑采用钬激光剜除术,因其出血风险小,能明显缩短导尿管留置时间和住院时间.

Objectives To compare the clinical effect between transurethral holmium laser enucleation and transurethral plasmakinetic resection for treatment of benign prostatic hyperplasia（BPH）.Methods 83 patients with BPH in our hospital from January 2013 to December 2014 were randomly divided into two groups：42 patients who underwent transurethral holmium laser enucleatiou and 41 patients who underwent plasmalinetic energy transurethral resection of the prostate （PKRP）,and the operative time,blood loss,the length of hospital stay,complications,residual urine,indwelling time of catheter,compare the differences of international prostate symptoms score （IPSS） were analyzed before and after operation.Results The amount of blood loss and operation time of the holmium laser group were less than that of the PKRP group.The indwelling time of catheter and the length of hospital stay were shorter than that in PKRP group （P 〈 0.05）.The IPSS and residual urine volume of the two groups were significantly decreased（P 〈 0.05）.There was no significant difference in IPSS and residual urine volume between two groups before operation.There was no significant difference in IPSS and residual urine volume between the two groups after operation（P 〉0.05）.The incidence of complications in the two groups was not statistically significant （P 〉 0.05）.Conclusions Holmium laser or PKRP in the treatment of benign prostatic hyperplasia were also obtained with good efficacy and safety.We can choose the way of holmium laser enucleation,because it can significantly reduce the risk of blood loss,shorten the indwelling catheter time and hospitalization time for patients with transurethral resection of the prostate operation contraindication.