HoLEP对BPH患者尿流动力学和血清T-PSA、F-PSA水平的影响

The effect of holmium laser enucleation of the prostate on urodynamics and serum T-PSA and F-PSA levels in patients with benign prostatic hyperplasia

目的探讨经尿道前列腺激光剜除术(HoLEP)对良性前列腺增生(BPH)患者的尿流动力学和血清总前列腺特异性抗原(T-PSA)、游离前列腺特异性抗原(F-PSA)水平的影响。方法选取2021年1月至2023年6月在本院收治的128例BPH患者作为研究对象,采用随机数表法将患者分为观察组(HoLEP治疗,64例)和对照组[经尿道等离子前列腺电切术(PKEP)治疗,64例]。比较两组患者的手术指标、治疗前后尿流动力学指标、血清T-PSA、F-PSA水平及性功能,并随访术后并发症。结果观察组的术中出血量少于对照组,膀胱冲洗、尿管留置及住院时间均短于对照组,差异均有统计学意义(均P<0.05)。两组治疗后的最大尿流量、最大膀胱容量和残余尿量均优于治疗前,且治疗后观察组的尿流动力学指标优于对照组,差异均有统计学意义(均P<0.05)。两组治疗后的T-PSA、F-PSA水平均较治疗前降低,且治疗后观察组的T-PSA、F-PSA水平降低幅度大于对照组,差异均有统计学意义(均P<0.05)。两组治疗后的IIEF-5、CIPE评分均较高于治疗前,且治疗后观察组的IIEF-5、CIPE评分高于对照组,差异均有统计学意义(均P<0.05)。观察组的术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论HoLEP治疗BPH较PKEP具有创伤小、恢复快的特点,有利于改善患者尿动力学指标及血清T-PSA、F-PSA水平,对患者性功能影响小,且并发症少。

ObjectiveTo observe the therapeutic effect of holmium laser enucleation of the prostate(HoLEP)on patients with benign prostatic hyperplasia(BPH)and its impact on urodynamics and serum levels of total prostate-specific antigen(T-PSA)and free prostate-specific antigen(F-PSA).MethodsA total of 128 BPH patients admitted to our hospital from January 2021 to June 2023 were selected as the study objects,and the patients were divided into observation group(HoLEP treatment,64 cases)and control group(PKEP treatment,64 cases)by random number table method.The surgical indexes,urinary flow dynamics indexes,serum T-PSA,F-PSA levels and sexual function before and after treatment were compared between the two groups,and postoperative complications were followed up.ResultsThe intraoperative blood loss in the observation group was less than that in the control group,and the duration of bladder irrigation,urinary catheter indentation and hospitalization were shorter than those in the control group(all P<0.05).After treatment,the maximum urinary flow,maximum bladder capacity and residual urine volume of the two groups were better than before treatment,and the urinary flow dynamics indexes of the observation group were better than the control group after treatment(all P<0.05).The T-PSA and F-PSA levels of the two groups after treatment were lower than those before treatment,and the T-PSA and F-PSA levels of the observation group after treatment were lower than those of the control group(all P<0.05).IIEF-5 and CIPE scores after treatment were higher than those before treatment,and IIEF-5 and CIPE scores in observation group were higher than those in control group after treatment(all P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).ConclusionsHoLEP surgery for BPH has less trauma and faster recovery compared to PKEP surgery,which is beneficial for improving the patient's urodynamic indicators and serum T-PSA and F-PSA levels.It has less impact on the patient′s sexual function and fewer complications.