基于术中出血量和血清相关因子水平探讨经尿道前列腺绿激光选择气化术与经尿道前列腺电切术治疗前列腺增生的临床价值

To Evaluate the Clinical Value of Transurethral Green Laser Vaporization and Transurethral Electroresection of Prostate in the Treatment of Prostatic Hyperplasia Based on the Amount of Blood Loss and Serum Related Factors

目的基于术中出血量和血清相关因子水平探讨经尿道前列腺绿激光选择气化术与经尿道前列腺电切术治疗前列腺增生的临床价值。方法收集2020年05月—2022年10月31日期间本院医治的139例前列腺增生患者,根据不同手术方法分为激光组(n=71)、电切组(n=68)。前者行经尿道前列腺绿激光选择气化术,后者行经尿道前列腺电切术。比较两组手术指标、手术前后尿动力学指标、性功能状况、炎性-应激反应[白细胞介素-4(IL-4)、5-羟基色胺(5-HT)、白细胞介素-17(IL-17)]及并发症状况。结果与电切组相比,激光组膀胱冲洗时间、导尿管滞留时间、住院时间、出血量均较少(P<0.05);两组前列腺切除量、手术时间相比,差异无统计学意义(P>0.05);术后1个月,两组膀胱容量、膀胱顺应性均显著上升,残余尿量显著下降(P<0.05);但组间相比,差异无统计学意义(P>0.05);术后1个月,激光组IIEF-5评分高于电切组,激光组逆行射精发生率(0.00%)低于电切组(8.82%)(P<0.05);与电切组相比,激光组血清5-HT、IL-17水平较低,IL-4水平较高(P<0.05);激光组并发症发生率(2.82%)与电切组(7.35%)相比,差异无统计学意义(P>0.05)。结论前列腺增生患者行经尿道前列腺绿激光选择气化术能减轻机体炎性-应激反应,改善尿动力学指标和性功能,减少术中出血量,预后效果较好。

Objective To investigate the clinical value of transurethral green laser selective vaporization of prostate and transurethral electroresection of prostate in the treatment of prostate hyperplasia based on the amount of blood loss and serum related factors.Methods A total of 139 patients with prostatic hyperplasia treated in our hospital from May 2020 to October 31,2022 were collected and divided into laser group(n=71) and electric resection group(n=68) according to different surgical methods.The former underwent transurethral green laser selective vaporization of the prostate,while the latter underwent transurethral resection of the prostate.The surgical indexes,urodynamic indexes,sexual function,inflammatory stress response [interleukin-4(IL-4),5-hydroxytryptamine(5-HT),interleukin-17(IL-17)] and complications were compared between the two groups.Results Compared with the electrotomy group,the bladder irrigation time,catheter retention time,hospital stay time and blood loss in the laser group were less(P<0.05).There was no significant difference in the amount of prostate resection and operation time between the two groups(P>0.05).One month after surgery,bladder volume and bladder compliance were significantly increased,while residual urine volume was significantly decreased in both groups(P<0.05).However,there was no significant difference between groups(P>0.05).One month after surgery,IIEF-5 score in laser group was higher than that in electrotomy group,incidence of retrograde ejaculation in laser group(0.00%) was lower than that in electrotomy group(8.82%)(P<0.05).Compared with the electrotomy group,the serum levels of 5-HT and IL-17 in the laser group were lower,and the serum levels of IL-4 were higher(P<0.05).There was no significant difference in the incidence of complications between the laser group(2.82%) and the electrical group(7.35%)(P>0.05).Conclusions Transurethral prostate green laser selective vaporization for patients with prostatic hyperplasia can alleviate inflammatory stress response,improve urodynamic index and sexual function,reduce intraoperative blood loss,and have a good prognosis.