经尿道钬激光前列腺剜除术与经尿道前列腺电切术治疗前列腺增生的疗效比较

Comparison of efficacy in the treatment of prostatic hyperplasia between transurethral holmium laser ablation 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(Ho LEP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的疗效及安全性。方法良性前列腺增生患者92例,随机分为两组,每组46例,分别行经尿道钬激光前列腺剜除术或经尿道前列腺电切术。监测并记录各患者在围手术期和术后1、3、6个月的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿量(PVRU)及生活质量评分(QOL)等指标。结果与TURP组比较,Ho LEP组的手术时间延长、术后留置导尿管和住院时间缩短,术中出血量及术后低钠血症发生率降低(P<0.01或0.05);除低钠血症外的其他手术后并发症,以及术后1、3、6个月两组患者的IPSS评分、Qmax、PVRU及QOL评分,两组间的差异无统计学意义(P>0.05)。结论在外科治疗BPH上,Ho LEP与TURP的近期手术效果相似,而HoLEP的手术安全性及恢复时间则优于TURP。

Objective To compare the efficacy and safety of holmium laser enucleation of the prostate（Ho LEP） and transurethral resection of the prostate（TURP） in the treatment of benign prostatic hyperplasia（BPH）. Methods 92 BPH patients were randomly divided into Ho LEP Group and TURP Group, 46 cases in each group, receiving Ho LEP and TURP, respectively. Monitor and record international prostste symptom score（IPSS）, the maximum urinary flow rate（Qmax）, postvoid residual urine volume（PVRU） and quality of life score（QOL） of all the patients in perioperative period and 1, 3 and 6 months after operation. Results Compared with TURP Group, Ho LEP Group had a prolonged operation duration, shortened postoperative catheterization time and hospital stay, reduced intraoperative blood loss and decreased incidence of postoperative hyponatremia（P〈0.01 or 0.05）; there was no statistical difference in reducing other surgical complications except for hyponatremia and IPSS score, Qmax, PVRU and QOL score of the two groups 1, 3 and 6 months after operation（P〉0.05）. Conclusion For patients with BPH, the near-term curative effect of Ho LEP and TURP is similar, but Ho LEP is superior to TURP in terms of the safety and recovery time.