1470nm激光前列腺剜除术与经尿道等离子电切术的比较研究

Comparative study between transurethral prostate enucleation with 1470 nm laser and transurethral plasmakinetic prostatectomy in the treatment of benign prostatic hyperplasia

目的:比较经尿道1 470nm激光前列腺剜除术(LEP)和前列腺等离子电切术(TUPKP)治疗良性前列腺增生(BPH)的疗效及安全性。方法:将2016年5月~2017年12月我院收治的110例BPH患者随机分为两组,分别行LEP(58例)和TUPKP(52例)。监测、记录两组患者围手术期和术后6个月复查指标,比较两组术中出血量、术后膀胱持续冲洗时间、手术时间、导尿管留置时间及前列腺切除重量;比较术前与术后6个月患者的生命质量评分(QOL)、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、残余尿量(PVR)及前列腺特异性抗原(PSA);比较两组术后并发症情况。结果:LEP组的手术时间、术中出血量、术后膀胱持续冲洗时间及导尿管留置时间均低于TUPKP组(P<0.05),术中切除前列腺重量明显高于TUPKP组;术后6个月,两组QOL、Qmax、IPSS、PVR及PSA均低于术前(P<0.05),但两组比较差异均无统计学意义(P>0.05);LEP组并发症发生率为5.17%(3/58),低于TUPKP组的26.92%(14/52),两组比较差异有统计学意义(P<0.05)。结论:采用LEP和TUPKP治疗BPH患者治疗效果相当,但与TUPKP治疗比较,LEP具有出血量少、恢复迅速、切除腺体更为彻底、并发症发生率较低等优势。

Objective：To compare the efficacy and safety between 1 470 nm laser transurethral enucleation of the prostate（LEP）and transurethral plasmakinetic prostatectomy（TUPKP）for the treatment of benign prostatic hyperplasia（BPH）.Method：A total of 110 patients with BPH in our hospital from May 2016 to December 2017 were selected according to the random number table method,and they were divided into LEP group（58 cases）and TUPKP group（52 cases）.The LEP group was treated with 1 470 nm laser transurethral enucleation of the prostate,while reference group was treated by TUPKP.The amount of intraoperative bleeding,duration of postoperative bladder irrigation,operation time,indwelling time of urethral catheter and excised prostate weight between two groups were compared,the quality of life score（QOL）,maximum urinary flow rate（Qmax）,international prostate symptom score（IPSS）,the residual urine volume（PVR）and PSA before and 6 months after operation between two groups were compared,and the postoperative complications in two groups were compared.Result：The amount of intraoperative bleeding,duration of postoperative bladder irrigation,operation time,indwelling time of urethral catheter in LEP group were all lower than those in TUPKP group（P〈0.05）and excised prostate weight increased significantly in LEP group.Six months after operation,QOL,Qmax,IPSS,PVR and PSA in two groups were all lower than those of before operation（P〈0.05）,but there was no statistical difference between two groups（P〉0.05）.The incidence of complications in LEP group was 5.17%（3/58）,which was lower than 26.92%（14/52）of TUPKP group.The difference was statistically significant（P〈0.05）.Conclusion：Both 1470 nm laser transurethral enucleation of the prostate and TUPKP have significant therapeutic effects in the treatment of BPH.However,compared with the TUPKP treatment,1 470 nm laser transurethral enucleation of the prostate has the advantages of less bleeding,rapid recovery,more removing of prostate gland and lower incidence of complications.