三种手术器械在治疗高危重度前列腺剜除术中的对比

Comparison of Three Surgical Instruments in the Treatment of High-risk Severe Enucleation of the Prostate

目的探讨3种“剜除”治疗高危重度前列腺增生症手术器械,红激光、绿激光、等离子手术设备行前列腺剜除术(Enucleation)治疗高危重度前列腺增生症的疗效及安全性分析。方法回顾性分析2019年9月至2022年2月锦州医科大学附属第一医院泌尿外科应用3组手术器械行前列腺剜除手术治疗142例高危重度前列腺增生患者,分为红激光器械组42例、绿激光器械组38例、等离子器械组62例,总结分析切除前列腺质量、出血量、手术时间、术后1、6个月疗效及并发症等变化情况。结果红、绿激光手术器械组在手术时间(88.6±15.2)min、(86.3±16.2)min、出血量(30.3±6.1)mL、(31.2±5.9)mL、暂时性尿失禁1例(2.6%)、2例(4.7%)等方面均好于等离子组,差异具有统计学意义。术后IPSS、QoL、Qmax、RUV等各项指标3组较术前均有较大改善,差异有统计学意义。结论红激光、绿激光、等离子手术器械行前列腺剜除术治疗高危重度前列腺增生均安全有效;激光手术器械在手术时间、术中出血、并发症方面,表现更优。

Objective To investigate the efficacy and safety of three kinds of“Enucleation”surgical instruments in the treatment of high-risk severe prostatic hyperplasia,including red laser,green laser and plasma surgical equipment.Methods A retrospective analysis was performed on 142 patients with high-risk severe prostatic hyperplasia who underwent prostate enucleation with three groups of surgical instruments in Urinary Surgery Department of the First Affiliated Hospital of Jinzhou Medical University 2019 to now.They were divided into red laser instrument group(42 cases),green laser instrument group(38 cases)and plasma instrument group(62 cases).The weight of resected prostate,blood loss,operation time,efficacy at 1 month and 6 months after operation and complications were analyzed.Results In the red and green laser surgical instrument group,the operation time was(88.6±15.2)min and(86.3±16.2)min,and the blood loss was(30.3±6.1)ml and(31.2±5.9)ml,respectively.Temporary urinary incontinence in 1 case(2.60%)and 2 cases(4.70%)in the plasma group were better than those in the plasma group,and the difference was statistically significant.The postoperative IPSS,QoL,Qmax,RUV and other indicators of the three groups were significantly improved compared with those before operation,and the differences were statistically significant.Conclusion Red laser,green laser and plasma surgical instruments for prostate enucleation are safe and effective in the treatment of high-risk severe prostatic hyperplasia.Laser surgical instruments have better performance in terms of operation time,intraoperative bleeding and complications.