保留超过精阜远端腺体组织的经尿道180 WXPS绿激光前列腺汽化术对前列腺增生患者早期尿流动力学的影响

The effect of transurethral greenight 180-W XPS laser vaporization of the prostate sparingthe gland tissues beyond the distal end of the seminal colliculus on early urodynamics in patients with benign prostatic hyperplasia

目的探讨保留超过精阜远端腺体组织的经尿道180 WXPS绿激光前列腺汽化术对前列腺增生(BPH)患者早期尿流动力学的影响。方法乐山市人民医院收治的BPH患者164例,采用随机数表法分为观察组和对照组各82例,对照组采用经尿道180 WXPS绿激光剜除前列腺汽化术治疗,观察组采用保留超过精阜远端腺体组织的经尿道180 WXPS绿激光前列腺汽化术治疗,比较两种不同治疗方式对患者早期尿流动力学的影响。结果两组治疗总有效率比较,差异无统计学意义(P>0.05);观察组手术时间、术中出血量、留置导尿管时间、住院时间均低于对照组(P<0.05);治疗后观察组酸性磷酸酶(ACP)、精浆果糖(Fru)、α-葡萄糖苷酶(α-Glu)、前列腺症状评分(ⅡEF-5)、最大尿流率(Qmax)、最大尿道关闭压(MUCP)均高于对照组,勃起功能评分(IPSS)、残余尿量(RUV)低于对照组(P<0.05);治疗后两组肿瘤坏死因子(TNF-α)、白介素-8(1L-8)、C反应蛋白(CRP)升高,观察组低于对照组(P<0.05);术后两组血尿、尿路感染、尿道狭窄、膀胱刺激征发生率比较差异无统计学意义(P>0.05),观察组尿失禁发生率低于对照组(P<0.05)。结论保留超过精阜远端腺体组织的经尿道180 WXPS绿激光前列腺汽化术在BPH患者中应用较佳,可显著改善患者前列腺状态、性功能及尿流动力学,可在较小创伤治疗BPH。

Objective To investigate the effect of transurethral greenlight 180-W XPS laser vaporization of the prostatesparingthe gland tissues beyond the distal end of the seminal colliculuson early urodynamics in patients with benign prostatic hyperplasia(BPH).Methods One hundred and sixty-four BPH patients with BPH who were treated in our hospital were divided into experiment group and control group by random number table method,82 in each group.The control group was treated with transurethral greenlight 180-W XPS laser enucleation of the prostate,while the experiment group was treated with transurethral greenlight 180 W XPS laser vaporization of the prostatesparing the gland tissues beyond the distal end of seminal colliculus.Early urodynamics of the two groups were compared.Results There was no significant difference in the effective rate of treatment between the two groups(P>0.05).The operation time,intraoperative blood loss,catheter indwelling time and the length of hospital stay of the experiment group were significantly shorter or less than those of the control group(P<0.05).After treatment,theacid phosphatase(ACP),seminal fructose(Fru),α-glucosidase(α-Glu),prostate symptom scores(ⅡEF-5),maximum urinary flow rate(Qmax)and maximum urethral closure pressure(MUCP)of the experiment group were significantly higher than those of the control group,while erectile function scores(IPSS)and residual urine volume(RUV)were lower than those of the control group(P<0.05).After treatment,the levels of tumor necrosis factor(TNF-α),interleukin-8(1L-8)and C-reactive protein(CRP)were significantly increased,and these indicators in the experiment group were lower than those in the control group(P<0.05).There were no significant differences in the incidences of postoperative hematuria,urinary tract infection,urethral stricture and irritation symptoms of bladder between the two groups.The incidence of postoperative urinary incontinence in the experiment group was significantly lower than that in the control group(P<0.05).Conclusion Transurethral greenlight 180-W XPS laser vaporization of the prostate sparing the gland tissues beyond the distal end of seminal colliculus can achieve better effects in the treatment of patients with BPH.It can significantly improve the patients’prostate status,sexual function and urodynamics.It also treats BPH with minor trauma.