经尿道钬激光前列腺剜除术对老年BPH患者的影响

Effects of Trans-urethral Holmium Laser Enucleation of Prostate on Elderly Patients with BPH

目的:探讨经尿道钬激光前列腺剜除术(trans-urethral holmium laser enucleation of prostate,HoLEP)对老年良性前列腺增生(benign prostatic hyperplasia,BPH)患者的影响。方法:选取2021年6月—2022年6月大方县人民医院收治的92例老年BPH患者作为研究对象。根据随机数表法将其分为A组和B组,各46例。A组给予经尿道前列腺切除术(transurethral resection of prostate,TURP),B组给予HoLEP。比较两组术前、术后1个月相关指标、前列腺症状、生命质量及并发症分级。结果:术后1个月,两组最大尿流率(maximum urinary flow rate,Qmax)水平均提高,前列腺体积及前列腺特异性抗原(prostate specific antigen,PSA)水平均下降,B组Qmax水平高于A组,前列腺体积及PSA水平均低于A组,差异有统计学意义(P<0.05)。术后1个月,两组国际前列腺症状评分(international prostate symptom score,IPSS)评分降低,生命质量测定量表(quality of life instruments for chronic diseases-benign prostatic hyperplasia,QLICD-BPH)评分升高,B组IPSS评分低于A组,QLICD-BPH评分高于A组,差异有统计学意义(P<0.05)。B组Ⅱ级及Ⅳ级并发症发生率均低于A组,差异有统计学意义(P<0.05)。结论:HoLEP能够增加老年BPH患者Qmax,缩小其前列腺体积,缓解患者前列腺症状,提高其生命质量,同时有助于减少术后并发症。

Objective:To investigate the effect of trans-urethral holmium laser enucleation of prostate(HoLEP)on elderly patients with benign prostatic hyperplasia(BPH).Method:A total of 92 elderly patients with BPH treated in Dafang County People's Hospital from June 2021 to June 2022 were selected as research objects.They were divided into group A and group B according to random number table method,with 46 cases in each group.Group A was given transurethral resection of prostate(TURP)and group B was given HoLEP.The relevant indexes,prostate symptoms,quality of life before and 1 month after surgery and complication grade were compared between the two groups.Result:One month after surgery,maximum urinary flow rate(Qmax)level of both groups increased,prostate volume and prostate specific antigen(PSA)level decreased,and Qmax level of group B was higher than that of group A,prostate volume and PSA level were lower than those of group A,the differences were statistically significant(P<0.05).One month after surgery,international prostate symptom score(IPSS)score decreased in both groups,quality of life instruments for chronic diseases-benign prostatic hyperplasia(QLICD-BPH)score increased,the IPSS score of group B was lower than that of group A,and the QLICD-BPH score of group B was higher than that of group A,the differences were statistically significant(P<0.05).The incidence of complication of gradeⅡandⅣin group B was lower than that in group A,and the difference was statistically significant(P<0.05).Conclusion:HoLEP can increase Qmax of elderly patients with BPH,reduce prostate volume,relieve prostate symptoms and improve quality of life of patients,while helping to reduce postoperative complications.