经尿道国产掺铥激光和绿激光前列腺汽化剜除术治疗大体积前列腺增生的疗效比较

Clinical comparative report of the transurethral vapoenucleation of prostate with domestic Thulium fiber laser and greenlight laser in the treatment of patients with large volume benign prostatic hyperplasia

目的探讨经尿道前列腺国产掺铥激光汽化剜除术与国产绿激光汽化剜除术治疗大体积(>80 ml)良性前列腺增生(BPH)的临床疗效。方法回顾性分析2018年1月至2021年9月在我院行激光手术治疗的120例大体积BPH患者的资料(包括日间手术50例),其中掺铥激光汽化剜除术60例(含日间手术40例)、绿激光汽化剜除术60例(含日间手术10例),手术均由同一主任医师完成。对两组的手术时间、术后24 h血红蛋白下降值、术后住院时间、术后尿管留置时间、住院总费用和术后6个月时最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、膀胱残余尿量,以及术中、术后并发症发生情况等进行比较分析。结果120例BPH患者均顺利完成手术,50例日间手术患者24 h内均完成入院、手术和出院。掺铥激光汽化剜除术组和绿激光汽化剜除术组的手术时间、术后24 h血红蛋白下降值、术后住院时间和住院总费用分别为(85.0±7.8)min和(94.0±10.1)min、(3.1±0.4)g/L和(5.8±1.1)g/L、(1.00±0.01)d和(1.40±0.07)d、(8.0±0.8)千元和(8.8±0.5)千元,两组差异有统计学意义(P<0.001);其余指标及两组患者的并发症发生情况和术后6个月时的Qmax、IPSS、QOL、膀胱残余尿量等差异均无统计学意义(P>0.05)。结论采用国产掺铥激光和绿激光汽化剜除术治疗大体积BPH均具有良好的安全性和疗效;相对于绿激光,掺铥激光具有操作方便、手术时间短、止血效果好、治疗费用低等特点,尤其适合日间手术。

Objective To compare the safety and efficacy of the transurethral vapoenucleation of the prostate with Thuliun fiber laser(ThuVEP)and greenlight laser(GVEP)in the treatment of patients with large volume(>80 ml)benign prostatic hyperplasia(BPH),respectively.Methods From January 2018 to September 2021,the clinical data of 120 patients with large volume BPH in Yue Bei People’s Hospital were retrospectively analyzed,including 50 patients undergoing day surgery.All patients were divided into two groups.A total of 60 patients in the observation group including 40 patients undergoing day surgery were treated by ThuVEP and 60 patients in the control group including 10 patients undergoing day surgery were treated by GVEP.All patients were performed by the same chief surgeon in urology.The operation time,postoperative hemoglobin decrease,bladder irrigation time,postoperative hospitalization time,indwelling catheterization time,hospitalization expenses,postoperative complications and the maximum urinary flow rate(Qmax),international prostate symptom score(IPSS),quality of life score(QOL),residual urine volume(RUV)at 6 months after surgery were compared between the two groups,respectively.Results All operations were successfully completed.All day surgery patients accepted hospitalization,operation and got recovery from hospital within 24 hours.The operation time,postoperative blood loss,postoperative hospitaliza-tion time and total hospitalization cost were(85.0±7.8)min vs(94.0±10.1)min,(3.1±0.4)g/L vs(5.8±1.1)g/L,(1.00±0.01)d vs(1.40±0.07)d,(8.0±0.8)×103 RMB vs(8.8±0.5)×103 RMB in ThuVEP group and GVEP group,respectively,P<0.001.There was no significant difference in Qmax,IPSS,QOL,RUV,postoperative complications or oth-er indicators between the two groups.Conclusions ThuVEP and GVEP are both effective and safe in the treatment of pa-tients with large volume BPH.ThuVEP has the advantages of shorter operation time,earlier convenient operation,better bleeding and lower cost compared with GVEP,so it is especially worthy of application in the day surgery.