经尿道前列腺钬激光剜除术治疗良性前列腺增生的临床效果

Clinical effect of transurethral holmium laser enucleation of the prostate for benign prostatic hyperplasia

目的观察经尿道前列腺钬激光剜除术(HoLEP)治疗良性前列腺增生(BHP)患者的临床疗效。方法选择2020年11月至2021年7月杨凌示范区医院收治的80例BPH患者为研究对象,按照随机数表法分为观察组和对照组各40例,观察组患者采用HoLEP治疗,对照组患者采用经尿道前列腺等离子剜除术(PKEP)治疗。比较两组患者的围术期情况、术前及术后1 d的血红蛋白水平以及术后3个月、6个月的国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))、残余尿量(PVR)、前列腺特异性抗原(PSA)的变化及并发症发生情况。结果观察组患者的手术时间为(92.34±12.83)min,明显长于对照组的(74.29±10.52)min,术中出血量、膀胱冲洗时间、导尿管留置时间以及住院时间分别为(35.62±7.83)mL、(1.19±0.26)d、(4.21±0.84)d、(6.59±1.36)d,明显少于/短于对照组的(75.91±11.29)mL、(1.68±0.42)d、(5.58±1.02)d、(8.31±1.54)d,差异均有统计学意义(P<0.05);术后1 d,观察组患者的血红蛋白水平为(128.32±14.39)g/L,明显高于对照组的(116.07±13.18)g/L,差异具有统计学意义(P<0.05);两组患者术后3个月、6个月时,IPSS评分、QOL评分、Qmax、PVR以及术后6个月时的血清PSA水平比较差异均无统计学意义(P>0.05);观察组患者的并发症总发生率为7.50%,明显低于对照组的25.00%,差异具有统计学意义(P<0.05)。结论HoLEP治疗BPH可减少手术风险,促进患者术后恢复,且能降低并发症发生率,临床应用效果显著。

Objective To observe the clinical efficacy of transurethral holmium laser enucleation of prostate(HoLEP)in the treatment of benign prostatic hyperplasia(BHP).Methods A total of 80 BPH patients admitted to Yangling Demonstration Area Hospital from November 2020 to July 2021 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 40 cases in each group.The patients in the observation group were treated with HoLEP,and the patients in the control group were treated with transurethral plasma removal of prostate(PKEP).The perioperative situation,the changes of the hemoglobin levels at preoperative and postoperative 1 d,the changes of the international prostate symptom score(IPSS)score,quality of life score(QOL)score,maximum urine flow rate(Qmax),residual urine volume(PVR),prostate specific antigen(PSA)score at preoperative,postoperative 3 months and 6 months,and incidence of complications were compared between the two groups.Results The operation time in the observation group was(92.34±12.83)min,which was significantly longer than(74.29±10.52)min of the control group,while the intraoperative blood loss,bladder flushing time,catheter indwelling time,and length of hospital stay were(35.62±7.83)mL,(1.19±0.26)d,(4.21±0.84)d,(6.59±1.36)d,which were significantly less/shorter than(75.91±11.29)mL,(1.68±0.42),(5.58±1.02)d,(8.31±1.54)d in the control group(P<0.05).At postoperative 1d,the hemoglobin levels in the observation group was(128.32±14.39)g/L,which was significantly higher than(116.07±13.18)g/L in the control group(P<0.05).There was no statistically significant difference in IPSS score,QOL score,Qmax and PVR at 3 and 6 months after surgery,or in serum PSA level at 6 months after surgery between the two groups(P>0.05).The total incidence of complications in the observation group was 7.50%,which was significantly lower than 25.00%in the control group(P<0.05).Conclusion HoLEP in the treatment of BPH can reduce the risk of surgery,promote the postoperative recovery of patients,and reduce the incidence of complications,with significant clinical effects.