钬激光前列腺剜除术与传统TURP疗效及并发症比较

Comparison of Krypton Laser Prostatectomy and Traditional TURP Efficacy and Complications

目的比较钬激光前列腺剜除术(HoLEP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的疗效和并发症。方法选择2015年6月~2019年6月我院收治的BPH患者78例,采用随机数字表分组方法分为HoLEP组37例和TURP组41例。TURP组采用常规步骤切除增生前列腺组织,HoLEP组采用钬激光前列腺剜除术。比较两组手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)等指标变化及并发症发生情况。结果HoLEP组手术时间长于TURP组(P<0.05);导尿管留置时间、术后住院天数短于(P<0.01)。TURP组血清钠、血红蛋白均较术前降低(P<0.01)。术后1个月、6个月、1年2组患者IPSS、QOL、Qmax、PVR均较术前显著改善(P<0.01)。术后随访HoLEP组的近期及远期并发症少于TURP组(P<0.01)。结论HoLEP治疗BPH疗效和TURP相似,HoLEP切割精准、手术视野清晰,出血和并发症更少。

Objective To compare the efficacy and complications of holmium laser enucleation(HoLEP)and transurethral resection of prostate(TURP)in the treatment of benign prostatic hyperplasia(BPH).Methods 78 patients with BPH admitted to our hospital from June 2015 to June 2019 were enrolled.The patients were divided into HoLEP group(37 cases)and TURP group(41 cases)by random number table.The TURP group used conventional procedures to remove prostatic hyperplasia,and the HoLEP group underwent holmium laser enucleation.The changes of international prostate symptom score(IPSS),quality of life score(QOL),residual urine volume(PVR),and maximum urinary flow rate(Qmax)before and after surgery were compared between the two groups.Results The operation time of the HoLEP group was longer than that of the TURP group(P<0.05);the catheter indwelling time and the postoperative hospital stay was shorter than the TURP group(P<0.01).Serum sodium and hemoglobin in the TURP group were lower than those before surgery(P<0.01).The IPSS,QOL,Qmax and PVR of the patients at 1 month,6 months and 1 year were significantly improved compared with those before operation(P<0.01).The short-term and long-term complications of the HoLEP group were lower than those of the TURP group,and the statistical significance was significant(P<0.01).Conclusion The efficacy of HoLEP in the treatment of BPH is similar to that of TURP.HoLEP has precise cutting,clear surgical field,and less bleeding and complications.