经尿道铥激光腔内剜除术和等离子腔内剜除术治疗前列腺增生疗效评价

Curative effect of transurethral thulium laser intraluminal enucleation and plasma intraluminal enucleation in the treatment of benign prostatic hyperplasia

目的比较经尿道铥激光腔内剜除术和等离子腔内剜除术治疗前列腺增生的效果。方法选取2019年1~12月清远市人民医院泌尿外科收治的64例前列腺增生患者进行研究,采用随机数表法分为观察组和对照组各32例。对照组患者实施经尿道等离子腔内剜除术,观察组患者实施经尿道铥激光腔内剜除术。记录两组患者各项手术指标变化,比较两组患者术后2个月的治疗效果,以及术前和术后2个月的尿道功能、前列腺症状及生活质量评分。结果术后2个月,观察组患者的治疗总有效率为96.88%,明显高于对照组的78.13%,差异有统计学意义(P<0.05);观察组和对照组患者的术中出血量[(104.61±11.27) mL vs (140.52±11.28) mL]、手术时间[(51.77±3.02) min vs(64.39±3.04) min]、冲洗膀胱时间[(18.44±4.25) h vs (30.01±4.26) h]及留置导管时间[(3.95±1.02) d vs (4.78±1.03) d]比较,观察组明显少于或短于对照组,差异均有统计学意义(P<0.05);术前,两组患者的尿道功能、前列腺症状及生活质量比较差异均无统计学意义(P>0.05);术后2个月,观察组患者的最大尿流率为(23.74±1.72) mL/s,明显高于对照组的(21.16±1.73) mL/s、残余尿量为(9.23±1.08) mL,明显少于对照组的(12.45±1.09) mL,差异均有统计学意义(P<0.05);观察组患者的前列腺症状评分为(7.81±2.25)分,明显低于对照组的(15.74±2.26)分,生活质量评分为(82.44±4.28)分,明显高于对照组的(73.75±4.29)分,差异均有统计学意义(P<0.05)。结论与经尿道等离子腔内剜除术比较,经尿道前列腺铥激光腔内剜除术治疗前列腺增生更能有效降低患者的术中出血量,缓解临床症状,改善尿道功能及生活质量,值得临床推广。

Objective To compare the effects of transurethral thulium laser intraluminal enucleation and transurethral plasma intraluminal enucleation on prostate.Methods Sixty-four patients with prostatic hyperplasia admitted to the Department of Urology,Qingyuan People's Hospital from January 2019 to December 2019 were selected and divided into observation group and control group according to random number table,with 32 patients in each group.Patients in the control group underwent transurethral plasma enucleation,and patients in the observation group underwent transurethral thulium laser enucleation.The changes of various surgical indexes of the two groups were recorded.The treatment effect of the two groups at 2 months after operation,as well as the urethral function,prostate symptoms,and quality of life scores before and 2 months after operation were compared.Results Two months after the operation,the total effective rate of treatment in the observation group was 96.88%,which was significantly higher than 78.13%in the control group(P<0.05).The intraoperative bleeding volume,operation time,bladder flushing time,and catheter indwelling time in the observation group were significantly less or shorter than those in the control group(P<0.05):(104.61±11.27)mL vs(140.52±11.28)mL,(51.77±3.02)min vs(64.39±3.04)min,(18.44±4.25)h vs(30.01±4.26)h,(3.95±1.02)d vs(4.78±1.03)d.Before surgery,there was no statistically significant difference in urethral function,prostate symptoms,and quality of life scores between the two groups(P>0.05);2 months after the operation,the maximum urine flow rate of the observation group was(23.74±1.72)mL/s,which was significantly higher than(21.16±1.73)mL/s of the control group,and the residual urine volume was(9.23±1.08)mL,which was significantly less than(12.45±1.09)mL in the control group(P<0.05).The prostate symptom score of the observation group was(7.81±2.25)points,which was significantly lower than(15.74±2.26)points in the control group,and the quality of life score was(82.44±4.28)points,which was significantly higher than(73.75±4.29)points in the control group(P<0.05).Conclusion Compared with transurethral plasma intraluminal enucleation,transurethral laser thulium enucleation for the treatment of benign prostatic hyperplasia can effectively reduce the amount of intraoperative bleeding,alleviate the clinical symptoms of patients,and improve the urethral function and quality of life of patients,which is worthy of clinical promotion.