钬激光前列腺剜除术与经尿道等离子前列腺剜除电切术治疗良性前列腺增生的效果对比

Comparison of holmium laser enucleation and plasmakinetic enucleation of the prostate for benign prostatic hyperplasia

目的 评价并对比钬激光前列腺剜除术(HoLEP)和经尿道等离子前列腺剜除电切术(PKEP)治疗良性前列腺增生(BPH)的临床效果.方法 选择我院2013年1月至2014年6月BPH患者共86例,分别接受HoLEP(HoLEP组,40例)或PKEP(PKEP组,46例)治疗,评价两组患者手术前及术后3个月残余尿量(PVR)、国际前列腺症状评分(IPSS),生活质量(QOL)评分,最大尿流率(MFR)等指标,并记录术中出血量、手术时间、切除前列腺质量、膀胱冲洗时间、留置导尿时间、术后住院时间等围手术期相关指标.结果 术后3个月,两组PVR、IPSS、QOL、MFR等指标较术前均显著改善(P值均为0.000),但组间比较差异均无统计学意义(P均＞0.05);HoLEP组术中出血量低于PKEP组[(69.5±23.6) ml与(87.5±38.0)ml,P=0.011],其余指标比较差异均无统计学意义(P均＞0.05).结论 HoLEP和PKEP治疗前列腺良性增生的临床效果相当,但HoLEP出血量更少.

Objective To evaluate and compare the efficacy of holmium laser enucleation of the prostate(HoLEP) and plasmakineticenucleation of the prostate(PKEP) for treating benign prostatic hyperplasia (BPH).Methods A total of 86 cases of BPH were selected from the Shandong Energy Zibo Mining Group Co.Ltd Central Hospital from January 2013 to June 2014.The patients received either HoLEP (40 cases) or PKEP(46 cases) treatment.Clinical data including postvoid residual volume (PVR),international prostate symptom score(IPSS),quality-of-life score(QOL score),maximum urinary flow rate (MFR) were evaluated before and 3 months after operation.Blood loss in operation,operation time,weight of resected prostate tissue,bladder irrigation time,catheterization time and length of hospital stay were also collected from the perioperative period.Results Three months after surgery,PVR,IPSS,QOL and MFR were all significantly improved in both HoLEP and PKEP groups compared with the data before operation (P =0.000),while there was no significant difference between the two groups(P＞0.05).Patients from the HoLEP group showed markedly lower values of bone loss in operation than that of PKEP group((69.5±23.6) ml vs.(87.5±38.0) ml,P=0.011).There were no significant differences in terms of other indexes (P＞ 0.05).Conclusion HoLEP and PKEP have similar efficiency in treating BPH,while HoLEP is suggested superior in regard of bone loss.