HoLEP和ThuLEP临床疗效的前瞻性随机对照研究

Prospective randomized comparison between holmium laser enucleation of the prostate and thulium laser enucle⁃ation of the prostate

目的比较经尿道前列腺钬激光剜除术(HoLEP)和经尿道前列腺铥激光剜除术(ThuLEP)的围手术期参数及临床疗效的差异性。方法选择前列腺增生手术的患者102例,按照随机数字表法分为HoLEP组(n=52)和ThuLEP组(n=50)。比较两组的围手术期参数以及术后3个月、9个月的国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、前列腺特异性抗原(PSA)和最大流速(Q_(max))。结果HoLEP组和ThuLEP患者的手术时间、剜除时间、灌注量、留置导尿管时间、住院时间和剜除组织重量比较,差异均无统计学意义(t分别=1.30、1.56、1.25、0.56、1.25、-0.87,P均>0.05)。ThuLEP组患者术后的血红蛋白(Hb)水平高于HoLEP,差异有统计学意义(t=-2.16,P<0.05)。术后随访3个月和9个月时,两组患者的术后IPSS、PSA、PVR、QoL和Q_(max)评分比较,差异均无统计学意义(t分别=-1.56、1.48、1.20、1.56、1.25;-1.56、1.48、1.20、1.56、1.25,P均>0.05)。结论HoLEP和ThuLEP均能较好地缓解下尿路症状,疗效确切,安全性高。两者围手术期和随访参数无显著性差异,但ThuLEP术后Hb水平高于HoLEP。

Objective To compare the perioperative parameters and clinical efficacy of holmium laser enucleation of the prostate(HoLEP)and thulium laser enucleation of the prostate.Methods A total of 102 patients with benign prostatic hyperplasia were randomly divided into HoLEP group(n=52)and ThuLEP group(n=50).The perioperative parameters,IPSS,QOL,PVR,PSA and Q_(max) of the two groups were compared at 3 and 9 months after operation.Results There was no significant difference in operation time,enucleation time,perfusion volume,indwelling catheter time,hospital stay and enucleated tissue weight between HoLEP group and ThuLEP group(t=1.30,1.56,1.25,0.56,1.25,-0.87,P>0.05).The postoperative Hb level in ThuLEP group was significantly higher than that in HoLEP(t=-2.16,P<0.05).There was no significant difference in IPSS,PSA,PVR,QOL and Q_(max) scores between the two groups at 3 and 9 months of follow-up(t=-1.56,1.48,1.20,1.56,1.25,-1.56,1.48,1.20,1.56,1.25,P>0.05).Conclusion Both HoLEP and ThuLEP can alleviate lower urinary tract symptoms with definite curative effect and high safety.There is no significant difference in perioperative and follow-up parameters between the two groups.But the postoperative Hb level of ThuLEP is higher than that of HoLEP.