小功率钬激光前列腺剜除术与经尿道前列腺等离子剜除术治疗良性前列腺增生症疗效比较

Comparison of curative effect between low power holmium laser enucleation of prostate and transurethral plasma enucleation of prostate in the treatment of benign prostatic hyperplasia

目的比较小功率(60 W)钬激光前列腺剜除术(Ho LEP)与经尿道前列腺等离子剜除术(PKEP)治疗良性前列腺增生症(BPH)的临床效果。方法选取2017年7月-2018年6月广东省信宜市人民医院泌尿外科收治的BPH患者120例,根据治疗方法不同分为Ho LEP组与PKEP组,每组60例。Ho LEP组采用小功率(60 W) Ho LEP治疗,PKEP组采用PKEP治疗。比较2组手术时间、术中粉碎切割时间、剜除前列腺组织重量、术中出血量、术后导尿管留置时间、住院时间,比较2组术前、术后1个月国际前列腺症状评分(IPS-S)、最大尿流率(Qmax)及生活质量评分(QOL)。结果 Ho LEP组手术时间、术后导尿管留置时间及住院时间均短于PKEP组,术中出血量少于PKEP组,差异均有统计学意义(P <0. 01);2组术中粉碎切割时间及剜除前列腺组织重量比较差异均无统计学意义(P> 0. 05)。术后1个月,2组QOL评分及IPS-S评分均低于术前,Qmax均高于术前,差异均有统计学意义(P <0. 01);2组间QOL评分、IPS-S评分及Qmax比较差异均无统计学意义(P>0. 05)。结论小功率(60 W) Ho LEP与PKEP治疗BPH的效果相当,但小功率Ho LEP术中出血量更少,手术时间及住院时间更短,可首选小功率Ho LEP治疗,无钬激光时可选用PKEP治疗。

Objective To compare the clinical effects between low power( 60 W) holmium laser enucleation of the prostate( Ho LEP) and transurethral plasma enucleation of the prostate( PKEP) in the treatment of benign prostatic hyperplasia( BPH). Methods 120 patients with BPH who were admitted to the Department of Urology,Xinyi People’ s Hospital,Guangdong Province from July 2017 to June 2018 were selected,according to different treatment methods,they were divided into Ho LEP group and PKEP group,60 cases in each group. The Ho LEP group was treated with low power( 60 W) Ho LEP,and the PKEP group was treated with PKEP. The operation time,intraoperative comminuted and incision time,weight of enucleated prostate tissue,intraoperative blood loss,postoperative catheter indwelling time,and hospital stay were compared between the two groups,the international prostate symptom score( IPS-S),maximum urine flow rate( Qmax) and quality of life score( QOL) were compared between the two groups before and one month after surgery. Results The operative time,postoperative catheter indwelling time,hospitalization time and intraoperative blood loss in Ho LEP group were significantly lower than those in PKEP group( P < 0. 01);There was no difference in intraoperative crush cutting time and enucleation of prostate tissue between the two groups( P > 0. 05). One month after operation,the QOL score and IPS-S score of the two groups were lower than before operation( P < 0. 01),and Qmax was higher than before operation( P < 0. 01);There was no significant difference between the two groups( P > 0. 05). Conclusion In the treatment of BPH,low power( 60 W) Ho LEP and PKEP have similar effects,but low power Ho LEP has less blood loss and shorter operation and hospitalization time,so low power Ho LEP therapy can be preferred,and PKEP therapy can be used in the absence of holmium laser.