经尿道前列腺钬激光剜除术与经尿道前列腺电切术在治疗前列腺增生中的临床疗效对比

Comparison of Clinical Efficacy Between Transurethral Resection of the Prostate and Laser Transurethral Resection of Prostate in the Treatment of Benign Prostatic Hyperplasia

目的评估经尿道前列腺钬激光剜除术(HOLEP)和经尿道前列腺电切术(TURP)在良性前列腺增生(BPH)治疗中的安全性和疗效。方法选择62例于2016年1月—2017年12月在该院行手术治疗的良性前列腺增生的患者,其中HOLEP组和TURP组各31例。通过比较手术时间、术中出血量、术后留置尿管时间、术后并发症发生率和术后住院天数评价两种手术方式的安全性,通过比较术前与术后3个月国际前列腺症状评分(I-PSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)等评价两种手术方式的疗效。结果 HOLEP组手术时间为(52.3±8.5)min、术中出血量为(40.5±12.4)mL、术后留置尿管时间为(3.5±1.2)d、术后住院天数(5.0±1.5)d均明显优于TURP组,差异有统计学意义(P<0.001),且HOLEP组术后并发症发生率为6.45%,较TURP组低,差异有统计学意义(χ~2=5.415,P<0.05);术后两组在I-PSS、QOL、Qmax、PRV较术前均明显改善,差异有统计学意义(P<0.05);但术后两组组间比较差异无统计学意义(P>0.05)。结论 HOLEP组与TURP组在治疗BPH的疗效中无明显差异,但在手术时间、术中出血量、术后留置尿管时间、术后并发症发生率和术后住院天数等方面HOLEP组的安全性更高。HOLEP手术在治疗BPH方面具有更好的应用前景。

Objective To evaluate the safety and efficacy of transurethral resection of the prostate （HOLEP） andtransurethral resection of the prostate （TURP） in the treatment of benign prostatic hyperplasia （BPH）. Methods Sixty-two patients with benign prostatic hyperplasia who underwent surgery in the hospital from January 2016 to December2017 were enrolled, including 31 in the HOLEP and TURP groups. The safety of the two surgical methods was evaluat-ed by comparing the operation time, intraoperative blood loss, postoperative indwelling catheter time, postoperativecomplication rate and postoperative hospital stay. The international prostate symptoms were compared before and 3months after surgery. The scores （I-PSS）, quality of life score （QOL）, maximum urinary flow rate （Qmax）, and residualurine volume （PVR） were evaluated for the efficacy of the two surgical procedures. Results The operation time of theHOLEP group was （52.3±8.5） min, the intraoperative blood loss was （40.5±12.4）mL, the postoperative indwellingcatheter time was （3.5±1.2） days, and the postoperative hospital stay was （5.0±1.5）days. The difference was statisticallysignificant （P〈0.001）, and the postoperative complication rate was 6.45% in the HOLEP group compared with the TURPgroup. The difference was statistically significant （χ2=5.415, P〈0.05）. The I-PSS, QOL, Qmax, and PRV weresignificantly improved in the two groups after operation,and the difference was statistically significant （P〈0.05）.However, there was no significant difference betweenthe two groups （P〈0.05）. Conclusion There is no sig-nificant difference between the HOLEP group and the TURP group in the treatment of BPH, but the HOLEP group in terms of operation time, intraoperative blood loss, post-operative indwelling catheter time, postoperative complication rate and postoperative hospital stay, more secure. HOLEPsurgery has a better application prospect in the treatment of BPH.