解剖标志沟联合尿道黏膜预离断技术在经尿道铥激光前列腺汽化剜除术中的应用

Research for the application of anatomic mark sulcus combined with urethral mucosa predissociation technique in transurethral thulium laser vapor enucleation of prostate

目的总结和评估解剖标志沟联合尿道黏膜预离断技术在经尿道铥激光前列腺汽化剜除术中的应用效果。方法回顾性分析2019年12月至2020年11月在芜湖市第二人民医院行经尿道铥激光前列腺汽化剜除术的131例良性前列腺增生患者的临床资料,按不同手术方法分为A组(行常规经尿道铥激光前列腺汽化剜除术,70例)和B组(采用解剖标志沟技术联合尿道黏膜预离断技术行经尿道铥激光前列腺汽化剜除术,61例)。比较两组的年龄、前列腺体积、手术前后最大尿流率(Q_(max))、国际前列腺症状评分(IPSS)、血红蛋白下降值以及腺体切除时间等相关指标。结果所有手术均顺利完成,两组手术前后的血红蛋白下降值、术后膀胱冲洗时间、术后留置尿管时间、住院时间比较,差异均无统计学意义(均P>0.05)。B组的腺体切除时间少于A组,差异有统计学意义(P<0.05)。B组手术后的IPSS评分、术后Q_(max)优于A组,差异均有统计学意义(均P<0.05)。B组的术后拔管当日即时尿控率优于A组,差异有统计学意义(P<0.05)。两组的手术并发症发生情况比较,差异无统计学意义(P>0.05)。结论经尿道铥激光前列腺汽化剜除术中联合解剖标志沟和尿道黏膜预离断技术治疗前列腺增生疗效确切,可有效防止压力性尿失禁的发生,缩短手术时间和学习曲线。

Objective To summarise and evaluate the application effect of the technique combined with anatomic mark sulcus and urethral mucosa predissociation in transurethral thulium laser vaporenucleation of prostate.Methods The clinical data of 131 patients with benign prostatic hyperplasia who underwent transurethral thulium laser vaporenucleation of the prostate from December 2019 to November 2020 at the Second People′s Hospital of Wuhu City were retrospectively analyzed.Group A(70 cases of conventional transurethral thulium laser prostatectomy)and group B(61 cases of anatomic marker groove technique combined with urethral mucosa predissection)were divided into two groups according to different surgical methods.The age,prostate volume,maximum flow rate(Q_(max)),international prostate symptom score(IPSS),hemoglobin decline and glandular excision time and other related indicators were compared between the two groups.Results All the operations were successfully completed,and there was no significant difference in hemoglobin decrease,postoperative bladder irrigation time,postoperative indwelling catheter time and hospital stay between the two groups(all P>0.05).The time of glandectomy in group B was less than that in group A,and the difference was statistically significant(P<0.05).The IPSS score and Q_(max)in group B were better than those in group A,and the differences were statistically significant(all P<0.05).The immediate urine control rate of group B on the day after catheter removal was better than that of group A,and the difference was statistically significant(P<0.05).There was no significant difference in surgical complications between the two groups(P>0.05).Conclusions Transurethral thulium laser vaporenucleation of prostate combined with the technique of anatomic mark sulcus and urethral mucosa predissociation is effective in the treatment of benign prostatic hyperplasia,which can effectively prevent the occurrence of stress urinary incontinence and shorten the operation time and learning curve.