经尿道摩西钬激光前列腺剜除术治疗良性前列腺增生的临床疗效分析

Clinical Efficacy of Transurethral Moses Holmium Laser Enucleation of the Prostate in Benign Prostatic Hyperplasia

目的:研究对于良性前列腺增生患者应用经尿道摩西钬激光前列腺剜除术治疗的效果。方法:于本院良性前列腺增生(BPH)患者中随机抽取82例,分为对照组[41例,经尿道前列腺等离子电切术(TURP)]和观察组[41例,经尿道摩西钬激光前列腺剜除术(MoLEP)],对比两组疗效。结果:观察组术中出血(42.80±4.71)mL,留置导管(3.62±0.64)d,手术时间(55.38±2.47)min,显著优于对照组[术中出血(64.72±4.15)mL,留置导管(5.74±0.90)d,手术时间(68.35±4.86)min],P<0.05。观察组Qave(13.48±1.82)mL/s,Qmax(11.12±2.23)mL/s,PVR(45.82±5.29)mL,显著优于对照组[Qave(11.68±2.62)mL/s,Qmax(9.16±2.74)mL/s,PVR(61.45±4.18)mL],P<0.05。观察组IPSS(5.10±1.95)分,QoL(2.14±0.58)分,显著优于对照组[IPSS(9.24±1.87)分,QoL(3.42±0.62)分],P<0.05。观察组膀胱痉挛1例(2.44%),包膜穿孔1例(2.44%),未见尿路感染、尿潴留,合计2例(4.88%),显著少于对照组[尿路感染2例(4.88%),膀胱痉挛2例(4.88%),尿潴留4例(9.76%),包膜穿孔3例(7.32%),合计11例(26.83%)],P<0.05。结论:对于良性前列腺增生患者应用经尿道摩西钬激光前列腺剜除术治疗有利于减少手术出血,缩短置管和手术时间,术后排尿功能和症状康复速度更快,能够恢复正常生活,尤其是术后并发症少,疗效和安全性有明显优势。

Objective:To study the effect of transurethral holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia.Methods:82 patients with benign prostatic hyperplasia(BPH)were randomly selected and divided into control group[41 patients,transurethral prostate plasma resection(TURP)]and observation group[41 patients,transurethral Moses holmium laser enucleation(MoLEP)]were compared with the two groups.Results:Intraoperative bleeding(42.80±4.71)mL,indwelling catheter(3.62±0.64)d,operative time(55.38±2.47)min was significantly better than the control group[intraoperative bleeding(64.72±4.15)mL,indwelling catheter(5.74±0.90)d,operation time(68.35±4.86)min)](P<0.05).Qave(13.48±1.82)mL/s,Qmax(11.12±2.23)mL/s,PVR(45.82±5.29)mL was significantly better than the control group[Qave(11.68±2.62)mL/s,Qmax(9.16±2.74)mL/s,PVR(61.45±4.18)mL)](P<0.05).IPSS of observation group and IPS(5.10±1.95)and QoL(2.14±0.58)were significantly better than control group[IPSS(9.24±1.87)and QoL(3.42±0.62)](P<0.05).In the observation group,1 bladder spasm(2.44%),1 capsule perforation(2.44%),no urinary tract infection or urinary retention,2(4.88%),significantly less than the control group[2 urinary tract infection(4.88%),2 bladder spasm(4.88%),4 urinary retention(9.76%),3 capsule perforation(7.32%),totaling 11 cases(26.83%)],with P<0.05.Conclusion:Transurethral Moses holmium laser enucleation for patients with benign prostatic hyperplasia is beneficial to reduce surgical bleeding,shorten catheter placement and operation time,faster postoperative urination function and symptom recovery,normal life,especially less postoperative complications,efficacy and safety.