经尿道前列腺钬激光剜除术治疗良性前列腺增生的效果及其对血清前列腺特异抗原、表皮生长因子、前列腺素E2水平的影响

Effect of Transurethral Holmium Laser Enucleation of the Prostate in the Treatment of Benign Prostatic Hyperplasia and its Effect on Serum Prostate-specific Antigen,Epidermal Growth Factor,and Prostaglandin E2 Levels

目的:探讨经尿道前列腺钬激光剜除术(HoLEP)治疗良性前列腺增生(BPH)的效果及其对血清前列腺特异抗原(PSA)、表皮生长因子(EGF)、前列腺素E2 (PGE2)水平的影响,有助于评估患者术后的病情变化。方法:选取2020年1月—2021年12月佳木斯市中心医院收治的104例BPH患者作为研究对象,按照随机数表法分为两组,每组各52例。对照组行经尿道前列腺电切术(TURP),观察组行HoLEP。比较两组患者手术切除效果及术后恢复情况、尿动力学[最大尿流率(Qmax)、压力-流率值(A-G)、残余尿量(RV)]、血清PSA、EGF、PGE2水平及并发症。结果:观察组术中出血量、膀胱冲洗时间、留置尿管时间、住院时间少于对照组,切除的前列腺重量大于对照组,差异有统计学意义(t=44.747、45.693、52.019、41.767、9.209,P<0.05);术后3个月,两组患者Qmax升高,A-G值、RV降低,且观察组Qmax高于对照组,A-G值、RV低于对照组,差异有统计学意义(t=12.425、12.366、33.397,P<0.05)。术后7 d,两组患者PSA、EGF、PGE2水平下降,且观察组低于对照组,差异有统计学意义(t=55.591、16.728、19.169,P<0.05);观察组并发症率与对照组比较,差异无统计学意义(χ^(2)=0.537,P>0.05)。结论:HoLEP治疗BPH可减少术中出血量,更彻底剜除组织,促进术后恢复,并可改善术后尿动力学,降低血清PSA、EGF、PGE2水平,改善预后。

Objective:To investigate the effect of transurethral holmium laser enucleation of the prostate(HoLEP) for benign prostatic hyperplasia(BPH) and its effect on serum prostate-specific antigen(PSA),epidermal growth factor(EGF),and prostaglandin E2(PGE2) levels,which will help to assess the postoperative changes in patients' conditions.Methods:104 patients with BPH admitted to the hospital from January 2020 to December 2021 were selected as the study population and divided into two groups according to the random number table method,with 52 cases in each group.The control group underwent transurethral resection of prostate(TURP) and the observation group underwent HoLEP.The surgical resection results and postoperative recovery,urodynamics(maximum urinary flow rate [Qmax],pressure-flow rate values [A-G],residual urine volume [RV]),serum PSA,EGF,PGE2 levels and complications were compared between the two groups.Results:The intraoperative bleeding,bladder flushing time,indwelling urinary catheter time,and hospital stay were less in the observation group than in the control group,and the weight of the resected prostate was greater than in the control group,with statistically significant differences(t=44.747,45.693,52.019,41.767,9.209,P<0.05).At 3 months after surgery,Qmax increased and A-G value and RV decreased in both groups,and Qmax in the observation group was higher than that in the control group,and A-G value and RV were lower than those in the control group,with statistically significant differences(t=12.425,12.366,33.397,P<0.05).At 7 d after surgery,PSA,EGF and PGE2 levels decreased in both groups and were lower in the observation group than in the control group,with statistically significant differences(t=55.591,16.728,19.169,P<0.05).There was no statistically significant difference in the complication rate in the observation group compared with the control group( χ^(2)=0.537,P>0.05).Conclusion:HoLEP for BPH can reduce intraoperative bleeding,enucleate tissue more thoroughly,promote postoperative recovery,and improve postoperative urodynamics,reduce serum PSA,EGF,and PGE2 levels,and improve prognosis.