选择性经尿道铥激光前列腺汽化切除联合膀胱颈多点切开术治疗小体积前列腺增生的疗效分析

Therapeutic effect of selective transurethra thulium laser vaporesection of prostate combined with bladder neck multi-point incision for small-volume prostatic hyperplasia

目的探讨经尿道铥激光汽化术联合膀胱颈多点切开治疗小体积前列腺增生的安全性及有效性.方法回顾性分析本院2014年1月至2018年9月收治的62例前列腺体积<30mL的前列腺增生患者的临床资料,其中32例行单纯经尿道前列腺切除术(TURP),30例行经尿道铥激光汽化切割术(TmLRP)联合膀胱颈多点切开术(TUBIN).观察指标包括手术时间、术后出血、住院时间及术后6个月随访结果.比较两组的IPSS评分、生活质量(QOL)、最大尿流率(Qmax)、残余尿(PVR)、膀胱颈挛缩、尿失禁情况、膀胱出口梗阻指数(BOOI)并进行分析.结果两组患者在手术时间、术后出血、住院时间、尿失禁方面比较,差异无统计学意义(P>0.05),两组Qmax、残余尿和膀胱颈挛缩比较,观察组优于对照组(P<0.05).结论经尿道铥激光汽化术联合膀胱颈多点切开术治疗小体积前列腺增生是一种安全性有效的方法.

Objective To investigate the safety and efficacy of transurethral thulium laser va-poresection of prostate combined with bladder neck multi-point incision for small-volume prostatic hyperplasia. Methods A retrospective analysis of the clinical records of 62 patients with prostatic hy-perplasia with prostate volume<30 mL admitted to our hospital from January 2014 to September 2018, 32 of whom received simple transurethral resection of the prostate( TURP), 30 cases was performed se-lective transurethral thulium laser vaporesection of prostate( TmLRP) combined with transurethral blad-der neck multi-point incision( TUBIN). Observations included operative time, postoperative bleeding, length of hospital stay and follow-up results at 6 months postoperatively. The IPSS score, quality of life ( QOL), maximum urinary flow rate( Qmax), residual urine( PVR), bladder neck contracture, urina-ry incontinence and bladder outlet obstruction index( BOOI) were compared between the two groups. Results Urethral holmium laser vaporization combined with bladder neck multi-point incision com-pared with surgery for simple transurethral resection of the prostate, postoperative bleeding, hospital stay, urinary incontinence, no significant difference ( P>0. 05 ). There was significant difference in residual urine and bladder neck contracture and Qmax(P<0. 05). Conclusions Transurethral thuli-um laser vaporesection combined with bladder neck multi-point incision for the treatment of small-vol- ume prostatic hyperplasia is safe and effective.