经尿道前列腺钬激光剜除术与经尿道前列腺双极等离子剜除术治疗良性前列腺增生的近期疗效比较

摘要

Objective To compare the short-term curative effects of holmium laser enucleation of the prostate ( Ho LEP) vs plasmakinetic enucleation of the prostate ( PKEP) in treatment of benign prostatic hyperplasia ( BPH).Methods Sixty cases of BPH were randomly divided into Ho LEP group ( treated with Ho LEP) and PKEP group ( treated with PKEP) by random number table method. The relevant data were collected during and after operation. IPSS, QOL, Qmax and PVR were recorded during the follow-up period. Results There were significant differences between Ho LEP group and PKEP group in the mean duration of operation[ ( 47. 6 ± 7. 1) min vs ( 74. 2 ± 9. 7) min], in bladder washing time[ ( 9. 3 ± 2. 1) h vs ( 16. 7 ± 4. 3) h], in the mean time of indwelling catheter[ ( 72. 8 ± 5. 1) h vs ( 79. 6 ±5. 4) h], in the mean duration of hospitalization[ ( 5. 9 ± 1. 7) d vs ( 8. 8 ± 1. 5) d], and in the decrease of hemoglobin[ ( 7. 0 ±1. 3) g/L vs ( 9. 6 ± 1. 7) g/L] ( P ＜ 0. 05). There were no significant differences in the mass of the excised prostates and the incidence of complications between the two groups ( P＞ 0. 05). There were no significant differences in IPSS, QOL, Qmax and PVR before and 6 months after operation between the two groups ( P＞ 0. 05). Conclusion Compared with PKEP group, Ho LEP group has less bleeding, shorter operation time, bladder washing time and hospitalization time in the treatment of BPH. Ho LEP may be the primary method of surgieal treatment for BPH.%目的 比较经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,Ho LEP)与经尿道前列腺双极等离子剜除术(plasmakinetic enucleation of the prostate,PKEP)治疗良性前列腺增生(benign prostatic hyperlasia,BPH)的近期疗效.方法 采用随机数字表法,将60例BPH患者分为两组,分别行Ho LEP及PKEP,对术中和术后数据进行收集,在随访中记录两组患者国际前列腺症状评分(IPSS)、生活质量指数评分(QOL)、最大尿流率(Qmax)和膀胱残余尿量(PVR)的情况.结果 Ho LEP组和PKEP组平均手术时间分别为(47.6±7.1)min和(74.2±9.7)min,膀胱冲洗时间分别为(9.3±2.1)h和(16.7±4.3)h,平均留置导尿管时间分别为(72.8±5.1)h和(79.6±5.4)h,平均住院时间分别为(5.9±1.7)d和(8.8±1.5)d,血红蛋白分别下降(7.0±1.3)g/L和(9.6±1.7)g/L,差异均有统计学意义(P ＜0.05).两组前列腺切除组织重量、并发症发生率差异无统计学意义(P＞ 0.05).两组患者间术前IPSS、QOL、Qmax、PVR与术后6个月差异无统计学意义(P＞ 0.05).结论 与PKEP组相比,Ho LEP组出血量更少,手术时间、膀胱冲洗时间、住院时间更短.Ho LEP可能成为BPH手术治疗的首选方法.