小功率钬激光剜除术治疗良性前列腺增生的疗效分析

Clinical analysis of low-power holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia

目的评价小功率钬激光剜除术(HoLEP)治疗良性前列腺增生(BPH)的临床疗效和安全性。方法回顾性分析2018年11月至2020年11月首都医科大学附属北京友谊医院诊治的70例BPH患者的临床资料。根据治疗方式的不同分为对照组和观察组,每组35例。对照组使用经尿道前列腺电切术(TURP)治疗,观察组采用经尿道小功率钬激光前列腺剜除术(HoLEP)治疗。统计分析两组围手术期指标,包括手术时间、住院时间、术后留置尿管时间、血红蛋白变化、组织切除量、手术并发症。比较两组术后3个月的国际前列腺症状评分法(IPSS)评分、生活质量(QOL)评分、最大尿流率(Qmax)、残余尿量(PVR)等指标。结果观察组住院时间、术后留置尿管时间、血红蛋白下降程度均小于对照组,组织切除量大于对照组,差异具有统计学意义(P<0.05)。两组术后3个月的IPSS、QOL评分、Qmax、PVR比较,差异无统计学意义(P>0.05)。结论小功率HoLEP治疗BPH安全可靠,与TURP效果相似,且在组织切除量、缩短住院及留置尿管时间、减少术中出血量方面更具有优势。

Objective To evaluate the clinical efficacy and safety of low-power holmium laser enucleation of the prostate(HoLEP)for the treatment of benign prostatic hyperplasia(BPH).Methods A retrospective analysis was conducted on the clinical data of 70 patients with BPH treated at Beijing Friendship Hospital,Capital Medical University from November 2018 to November 2020.Patients were divide into the control group and the observation group based on different treatment methods,with 35 cases in each group.The control group was treated with transurethral resection of the prostate(TURP),while the observation group was treated with transurethral low-power HoLEP.Data of perioperative indicators,including surgical duration,length of hospital stay,postoperative indwelling catheter time,hemoglobin changes,tissue resection volume,and surgical complications of two groups were analyzed.International prostate symptom scale(IPSS)score,quality of life(QOL)score,maximum urine flow rate(Qmax),and postvoid residual urine volume(PVR)between the two groups at 3 months after surgery were compared.Results The length of hospital stay,postoperative indwelling catheter time,and degree of hemoglobin decrease in the observation group were all lower than those in the control group,and tissue resection volume was larger than that in the control group,with statistical significance(P<0.05).There was no statistically significant difference in IPSS and QOL score,Qmax,and PVR between the two groups at 3 months after surgery(P>0.05).Conclusions The treatment of BPH with low-power HoLEP is safe and reliable,with similar efficacy compared to TURP,and has advantages in tissue resection volume,shortening hospital stay and indwelling catheter time,and reducing intraoperative bleeding.