经尿道钬激光膀胱颈切开治疗小体积良性前列腺增生合并膀胱梗阻的临床疗效及应用价值分析

Clinical efficacy and application value of transurethral holmium laser bladder neck incision for the treatment of small volume benign prostatic hyperplasia complicated with bladder neck obstruction

目的分析经尿道钬激光膀胱颈切开治疗小体积良性前列腺增生(BPH)合并膀胱颈梗阻的临床疗效及应用价值。方法选取2018年6月至2020年1月于本院住院治疗的48例小体积BPH合并膀胱颈梗阻患者作为研究对象,根据治疗方法的不同分为参照组与观察组,各24例。参照组采用药物保守治疗,观察组在参照组基础上给予经尿道钬激光膀胱颈切开术治疗,比较两组临床疗效、最大尿流率、最大逼尿肌压力、B超膀胱残余量、腹压、并发症发生情况。结果观察组治疗总有效率(95.83%)高于参照组(70.83%),差异有统计学意义(P<0.05)。治疗后,两组最大尿流率、最大逼尿肌压力均显著高于治疗前,且观察组高于参照组,差异有统计学意义(P<0.05)。治疗后,两组B超膀胱残余量少于治疗前,腹压小于治疗前,且观察组B超膀胱残余量少于参照组,腹压小于参照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。结论经尿道钬激光膀胱颈切开术可有效改善小体积BPH合并膀胱梗阻患者膀胱功能及排尿情况,降低并发症发生率,值得临床推广应用。

Objective To analyze the clinical efficacy and application value of transurethral holmium laser bladder neck incision for the treatment of small volume benign prostatic hyperplasia(BPH)complicated with bladder neck obstruction.Methods 48 patients with small volume benign BPH complicated with bladder neck obstruction who were hospitalized in our hospital from June 2018 to January 2020 were selected as the study subjects,and they were divided into reference group and observation group based on different treatment methods,with 24 cases in each group.Results The ref-erence group was treated with drug Conservative management,and the observation group was treated with transurethral holmium laser incision of blad-der neck on the basis of the reference group,the clinical efficacy,maximum urinary flow rate,maximum Detrusor muscle pressure,B-ultrasound resid-ual bladder volume,abdominal pressure,and complications were compared between the two groups.Results The total effective rate in the observa-tion group(95.83%)was higher than that in the reference group(70.83%),and the difference was statistically significant(P<0.05).After treatment,the maximum urinary flow rate and maximum Detrusor muscle pressure of the two groups were significantly higher than before treatment,and the ob-servation group was higher than the reference group,and the differences were statistically significant(P<0.05).After treatment,the residual bladder volume of the two groups were less than before treatment,abdominal pressure were lower than before treatment,and the residual bladder volume in the observation group was less than the reference group,abdominal pressure was lower than the reference group,and the difference was statistically signif-icant(P<0.05).There was no statistically significant difference in the incidence of complications between two groups.Conclusion Transurethral hol-mium laser bladder neck incision can effectively improve bladder function and urination in small volume benign BPH patients with bladder obstruc-tion,reduce the incidence of complications,and is worthy of clinical promotion and application.