钬激光剜除前列腺术与前列腺电切术治疗前列腺增生的疗效比较

Effect of HoLEP and TURP in treating benign prostatic hyperplasia

目的:比较钬激光剜除前列腺术(HoLEP)与前列腺电切术(TURP)治疗前列腺增生(BPH)的疗效。方法:选取108例BPH患者为研究对象,根据治疗方式不同分为对照组和观察组,每组各54例。对照组患者给予TURP治疗;观察组给予HoLEP治疗,术后随访6个月。比较两组患者手术情况(手术时间、出血量、膀胱冲洗时间)、术后恢复情况(尿管留置时间、住院时间)、术后并发症发生情况;术前及术后6个月尿动力学指标[最大尿流速度(Qmax)、排尿后残余尿量(PVR)、膀胱顺应性(BC)]、前列腺功能[前列腺症状(IPSS)评分]及勃起功能[国际勃起功能问卷-5(IIEF-5)评分]。结果:观察组患者手术时间、膀胱冲洗时间、术后导尿管留置时间及术后住院时间均短于对照组(P<0.05);术中出血量及并发症发生率均低于对照组(P<0.05)。术后6个月,两组患者Qmax、BC水平均升高(P<0.05),且观察组高于对照组(P<0.05);PVR水平、IPSS及IIEF-5评分均降低,且观察组低于对照组(P<0.05)。结论:相较于TURP,HoLEP可减少出血量,患者术后恢复快,值得临床推广使用。

Objective:To compare the effect of holmium laser enucleation of the prostate(HoLEP)and transurethral resection of the prostate(TURP)on benign prostatic hyperplasia(BPH).Methods:108 patients with BPH were enrolled and divided into control group and observation group according to different treatment methods,with 54 cases in each group.The control group was treated with TURP,the observation group was treated with HoLEP and followed up for 6 months after surgery.The surgical status(surgical time,bleeding volume,bladder flushing time),recovery status(urinary catheter retention time,hospital stay),occurrence of postoperative complications and urodynamic indicators[maximum urinary flow velocity(Qmax),residual urine output after urination(PVR),bladder compliance(BC)],prostate function[Prostate Symptom(IPSS)score]and erectile function[International Erectile Function Questionnaire 5(IIEF-5)score]before and 6 month after treatment were compared between groups.Results:The surgical time,bladder flushing time,urinary catheter retention time and hospital stay in observation group were shoter than those in control grop(P<0.05).The bleeding volume and incidence of complications of the observation group were lower than those of the control group(P<0.05).6 months after surgery,the Qmax and BC in both groups of patients increased(P<0.05),and the observation group was higher than the control group(P<0.05),the PVR level,IPSS,and IIEF-5 scores all decreased,and the observation group was lower than the control group(P<0.05).Conclusion:Compared with TURP,HoLEP can better reduce the bleeding volume,and the latter one has faster postoperative recovery of patients.It is worthy of clinical promotion.