经尿道钬激光前列腺剜除术治疗大体积前列腺增生患者的效果

Effects of transurethral holmium laser enucleation of the prostate in treatment of patients with large-volume prostatic hyperplasia

目的:探讨经尿道钬激光前列腺剜除术(HoLEP)治疗大体积前列腺增生患者的效果。方法:选取2020年7月至2021年8月该院收治的65例大体积前列腺增生患者进行前瞻性研究,按照随机数字表法分为对照组32例、观察组33例。对照组采用经尿道前列腺电切术(TURP)治疗,观察组采用HoLEP治疗,比较两组手术一般情况、手术前后泌尿系相关指标[国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿量(PVR)]水平,以及膀胱痉挛发生情况和并发症发生率。结果:观察组手术时间、膀胱冲洗时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组IPSS评分、PVR均低于对照组,Qmax高于对照组,膀胱痉挛发生频率少于对照组,持续时间短于对照组,疼痛程度低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为15.15%(5/33),低于对照组的37.50%(12/32),差异有统计学意义(P<0.05)。结论:HoLEP治疗大体积前列腺增生患者效果优于传统TURP,可有效缩短手术时间、膀胱冲洗时间及住院时间和减少术中出血量,促进排尿功能恢复,减轻术后膀胱痉挛发生程度,降低并发症发生率。

Objective:To explore effects of transurethral holmium laser enucleation(HoLEP)of the prostate in treatment of patients with large-volume prostatic hyperplasia.Methods:A prospective study was conducted on 65 patients with large-volume prostatic hyperplasia admitted to this hospital from July 2020 to August 2021.They were divided into control group(32 cases)and observation group(33 cases)according to the random number table method.The control group was treated with transurethral resection of prostate(TURP),while the observation group was treated with HoLEP.The general condition of the surgery,the urinary system related index[international prostate symptom score(IPSS),maximum urinary flow rate(Qmax),residual urine volume(PVR)]levels before and after the surgery,the occurrence of bladder spasm,and the incidence of complications were compared between the two groups.Results:The operation time,the bladder irrigation time and the hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).The IPSS score and the PVR level of the observation group were lower than those of the control group;the Qmax was higher than the control group;the frequency of bladder spasm was less than the control group,the duration was shorter than the control group,and the degree of pain was lower than the control group;and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 15.15%(5/33),which was lower than 37.50%(12/32)in the control group,and the difference was statistically significant(P<0.05).Conclusions:HoLEP is superior to traditional TURP in the treatment of the patients with-large volume prostatic hyperplasia.It can effectively reduce the operation time and the intraoperative blood loss,promote the recovery of urination function,shorten the bladder irrigation time and the hospitalization time,reduce the degree of postoperative bladder spasm,and reduce the incidence of complications.