大功率钬激光在前列腺钬激光剜除术治疗前列腺增生中的疗效及安全性研究

Study on the curative effect and safety of domestically high-power holmium laser in treating BPH by HoLEP

目的:研究分析采用大功率钬激光在经尿道前列腺钬激光剜除术(HoLEP)治疗前列腺增生中的临床疗效及安全性。方法:选取在医院就诊的352例前列腺增生患者,采用国产大功率钬激光和国产HAWK大白鲨组织粉碎器对所有患者行经尿道HoLEP手术治疗,并于剜除结束后对剜除组织粉碎吸出。研究分析患者术前、术中及术后的国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))、残余尿量(RUV)及并发症等情况,评价国产大功率钬激光行经尿道前列腺剜除术治疗良性前列腺增生的疗效及安全性。结果:352例患者手术均顺利完成,术后12个月患者的IPSS、QOL、Q_(max)和RUV较术前改善明显,差异有统计学意义(t=146.51,t=86.11,t=-52.42,t=36.35;P<0.01)。术后并发症率较低,手术输血率、术后膀胱颈硬化、尿道狭窄和压力性尿失禁分别为0.57%、0.85%、1.42%和6.82%。结论:国产大功率钬激光经尿道前列腺剜除术治疗良性前列腺增生,疗效确切,安全可行,并且设备成本较低,适合在各级医院开展。

Objective:To research and analyze the curative effect and safety of domestically high-power holmium laser in treating benign prostatic hyperplasia(BPH)by transurethral holmium laser enucleation of the prostate(HoLEP).Methods:352 patients with prostate hyperplasia who admitted to hospital were selected,and the high-power Holmium laser and domestically HAWK great shark tissue pulverator were adopted to implement transurethral HoLEP for all of patients.And then the excised tissue was crushed and suck out after the enucleation was completed.The preoperatively,intraoperatively and postoperatively international prostate symptoms score(IPSS),quality of life(QOL)score,the maximum flow rate(Qmax),residual urine volume(RUV)and complication were researched and analyzed.In addition,the curative effect and safety of domestically high-power Holmium laser in implementing transurethral HoLEP for treating BPH were further evaluated.Results:The surgeries of 352 patients were successfully completed,and the IPSS,POL,Qmax and RUV of the 12th month postoperative patients were significantly improved than those preoperative them(t=146.51,t=-52.42,t=36.35,P<0.01).And the rate of postoperative complication was lower,and the blood transfusion rate in operation,the rate of postoperative sclerosis of bladder neck,urethrostenosis rate and the rate of stress incontinence were 0.57%,0.85%,1.42%and 6.82%,respectively.Conclusion:The transurethral HoLEP with domestic high-power holmium laser in treating BPH has exact curative effect,and it is safe and feasibility.And its equipment cost is lower,and it is suitable for hospitals at all levels.