经尿道前列腺钬激光剜除术和经尿道前列腺电切术治疗良性前列腺增生比较

Efficacy and safety of holmium laser enucleation of the prostate versus trans-urethral resection of prostate in treatment of benign prostatic hyperplasia

摘要:

目的 探讨经尿道前列腺钬激光剜除术(HoLEP)对良性前列腺增生的治疗效果,并观察其安全性。方法 回顾性分析2015年2月至2016年12月在南京市中西医结合医院泌尿外科接受治疗的良性前列腺增生患者100例,根据治疗方案分为经尿道前列腺电切术(TURP)组和HoLEP组,每组50例,比较两组患者术前、术中情况和并发症以及术后国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和生活质量的改善。采用SPSS 11.5统计软件对数据进行分析。组间比较采用t检验或χ²检验。结果 两组患者年龄、最大尿流率(Qmax)、IPSS和膀胱残余尿量(PVUR)差异无统计学意义(P>0.05)。相比TURP组患者,HoLEP组患者手术时间短[(52.13±5.78) vs (60.48±6.57)min],术中出血量少[(78.22±7.83) vs (98.24±9.12)ml],前列腺切除质量多[(39.15±5.53) vs (30.26±4.68)g],术后Qmax和生活质量改善明显,差异具有统计学意义(P＜0.05)。TURP组患者16%(8/50)出现并发症,HoLEP组患者4%(2/50)出现并发症,差异具有统计学意义(P=0.046)。结论 HoLEP 对良性前列腺增生有较好的治疗效果,可明显降低IPSS,提高患者的生活质量。

Abstract:

Objective To investigate the therapeutic effectiveness of holmium laser enucleation of the prostate(HoLEP)for benign prostatic hyperplasia and observe its safety.Methods A retrospective analysis was conducted on 100 patients with benign prostatic hyperplasia admitted in our department from February 2015 to December 2016. According to their surgical treatment, they were divided into HoLEP group and transurethral resection of prostate (TURP) group, with 50 patients in each group. The general situations of the 2 groups of patients were observed preoperatively and intraoperatively, the incidence of complications and postoperative International Prostate Symptom Score (IPSS), maximum flow fate (Qmax) and improvement of quality of life were studied and compared between the 2 groups. SPSS statistics 11.5 was used to perform the statistical analysis. Student’s t test and Chi-square test were adopted for the comparison between the 2 groups. Results There were no significant differences in age, Qmax, IPSS and postvoidurine residual (PVUR) volume between the 2 groups (P>0.05).The patients of the HoLEP group had shorter operation time[(52.13±5.78) vs (60.48±6.57)min], less volume of intraoperative blood loss[(78.22±7.83) vs (98.24±9.12)ml], larger amount of prostate tissue resected[(39.15±5.53) vs (30.26±4.68)g], and greatly improved Qmax and quality of life, when compared with those of the TURP group (P<0.05). The incidence rate of complications was 16%(8/50) in the TURP group, and 4%(2/50) in the HoLEP group, with significant difference between them (P=0.046). Conclusion HoLEP has good curative effectiveness for benign prostatic hyperplasia, and it can significantly reduce IPSS and improve the quality of life of patients.