经尿道前列腺钬激光剜除术治疗对前列腺增生症患者尿控恢复及血清PSA、PGE_(2)水平的影响

Effects of urinary control recovery and serum PSA and PGE_(2)in patients with prostatic hyperplasia treated with transurethral holmium laser enucleation of the prostate

目的探讨经尿道前列腺钬激光剜除术(HoLEP)治疗对前列腺增生症(BPH)患者尿控恢复及血清前列腺特异性抗原(PSA)和前列腺素E_(2)(PGE_(2))水平的影响。方法选取2019年5月至2020年9月来该院就诊的88例BPH患者作为研究对象,采用随机数字表法分为观察组和对照组,每组44例。对照组患者实施经尿道前列腺电切术,观察组患者实施HoLEP,比较两组患者术前及术后残余尿量(PVR)、最大尿流量(Q max)和前列腺症状(IPSS)评分;对两组患者术后尿控恢复进行评价;比较两组患者术前及术后血清PSA和PGE_(2)水平;记录两组患者术后并发症发生情况。结果两组患者术后3个月PVR、IPSS评分均明显低于术前,且观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者术后3个月Q max明显高于术前,且观察组明显高于对照组,差异均有统计学意义(P<0.05)。术后12个月内随访,观察组患者术后1、3个月尿控恢复与对照组比较明显改善,差异均有统计学意义(P<0.05)。两组患者术后3个月血清PSA、PGE_(2)水平均明显低于术前,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。观察组患者术后膀胱损伤、膀胱痉挛、尿潴留、尿路感染、短暂性压力尿失禁和尿道口狭窄等总并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论HoLEP治疗BPH患者术后早期尿控恢复快,可降低患者血清PSA和PGE_(2)水平,促进患者康复,安全性较高。

Objective To investigate the effects of urinary control recovery in patients with benign prostatic hyperplasia(BPH)after the therapy of transurethral holmium laser enucleation of the prostate(HoLEP)and the effects on serum prostate specific antigen(PSA)and prostaglandin E_(2)(PGE_(2)).Methods A total of 88 patients with BPH who came to our hospital from May 2019 to September 2020 were selected as the research objects.They were randomly divided into observation group and control group,with 44 cases in each group.Transurethral resection of prostate(TURP)was performed in the control group and HoLEP was performed in the observation group.The preoperative and postoperative residual urine volume(PVR),maximum urinary flow(Q max)and prostate symptoms(IPSS)were compared between the two groups.The recovery of postoperative urinary control in the two groups was evaluated.The levels of serum PSA and PGE_(2)before and after operation were compared between the two groups.The postoperative complications were recorded.Results Three months after operation,PVR and IPSS in both groups were significantly lower than those before operation,and Q max was significantly higher than those before operation(P<0.05).Three months after operation,PVR and IPSS in observation group were significantly lower than those in control group,and Q max was significantly higher than those in control group(P<0.05).After 12 months follow-up,the urine control recovery in the observation group was significantly improved compared with that in the control group at 1 and 3 months after operation(P<0.05).The levels of serum PSA and PGE_(2)in the two groups were significantly lower than those before operation(P<0.05),and those in the observation group were significantly lower than those in the control group(P<0.05).Postoperative complications such as bladder injury,bladder spasm,urinary retention,urinary tract infection,transient stress urinary incontinence and urethral stricture in the observation group were significantly lower than those in the control group(P<0.05).Conclusion HoLEP treatment for BPH patients has a rapid recovery of urine control in the early postoperative period,which can reduce the serum PSA and PGE_(2)levels,promote patient recovery,and have a high safety.