“点线面体”四维法钬激光前列腺剜除术治疗良性前列腺增生的临床效果

Clinical effect of "point-line-surface-volume" four dimensional holmium laser enucleation of prostate in the treatment of benign prostatic hyperplasia

目的 探讨“点线面体”四维法钬激光前列腺剜除术治疗良性前列腺增生(BPH)的临床效果。方法 将2019年4月至2021年2月我院收治的62例BPH患者根据入院顺序的奇偶性分为对照组(31例,经尿道等离子前列腺电切术)和观察组(31例,“点线面体”四维法钬激光前列腺剜除术)。比较两组的临床效果。结果 观察组的治疗总有效率为96.77%,高于对照组的80.65%(P<0.05)。术后3个月,两组的最大尿流率、膀胱残余尿量、膀胱最大容量、膀胱顺应性均较术前改善,且观察组优于对照组(P<0.05)。术后3个月,两组的总前列腺特异性抗原(t PSA)水平均较术前降低,且观察组低于对照组(P<0.05)。观察组的并发症总发生率为6.45%,低于对照组的25.81%(P<0.05)。观察组的术中出血量少于对照组,膀胱冲洗时间及尿管留置时间短于对照组(P<0.05)。术后3个月,两组的国际前列腺症状评分(IPSS)及生活质量指数量表(QOL)评分均较术前降低,且观察组低于对照组(P<0.05)。术后3 d,两组的去甲肾上腺素(NE)、肾上腺素(E)及皮质醇(Cor)水平均较术前升高,但观察组低于对照组(P<0.05)。结论“点线面体”四维法钬激光前列腺剜除术治疗BPH的效果较好,可改善患者的控尿功能,降低t PSA水平及并发症发生率,缩短膀胱冲洗时间及尿管留置时间,提高生活质量,减轻创伤应激反应。

Objective To investigate the clinical effect of "point-line-surface-volume" four dimensional holmium laser enucleation of prostate in the treatment of benign prostatic hyperplasia(BPH).Methods A total of 62 patients with BPH admitted in our hospital from April 2019 to February 2021 were divided into control group(31 cases,transurethral plasma prostatectomy) and observation group(31 cases,"point-line-surface-volume" four dimensional holmium laser enucleation of prostate) according to the parity of admission order.The clinical effects of the two groups were compared.Results The total effective rate of treatment in the observation group was 96.77%,which was higher than 80.65% in the control group(P<0.05).Three months after operation,the maximum urine flow rate,residual urine volume of bladder,maximum bladder volume and bladder compliance of the two groups improved compared with those before operation,and those in the observation group were better than the control group(P <0.05).Three months after operation,the level of total prostate specific antigen(tPSA) in the two groups was lower than that before operation,and that in the observation group was lower than the control group(P<0.05).The total incidence of complications in the observation group was 6.45%,which was lower than 25.81% in the control group(P<0.05).The amount of intraoperative bleeding in the observation group was less than that in the control group,and the bladder flushing time and urinary tube retention time were shorter than those in the control group(P<0.05).Three months after operation,the International Prostate Symptom Score(IPSS) and Quality of Life Index(QOL) score of the two groups were lower than those before operation,and those in the observation group were lower than the control group(P<0.05).Three days after operation,the levels of norepinephrine(NE),epinephrine(E) and cortisol(Cor) in the two groups were higher than those before operation,but those in the observation group were lower than the control group(P <0.05).Conclusion The "point-line-surface-volume" four dimensional holmium laser enucleation of prostate in the treatment of BPH has better effect,it can ameliorate the patient’s urinary control function,reduce the level of tPSA and the incidence of complications,shorten the bladder flushing time and urinary tube retention time,improve the quality of life and relieve the traumatic stress reaction.