经尿道钬激光剜除和等离子电切术治疗良性前列腺增生的对比研究(1)
[摘要] 目的 比较经尿道钬激光前列腺剜除术(HOLEP)与等离子前列腺电切术(PKRP)治疗良性前列腺增生( BPH) 的效果。 方法 方便选取2017年1—12月收治该院的60例BPH 患者随机分入两组，每组30例，分别进行HOLEP或PKRP手术治疗。比较两组术中情况、术后疗效及并发症发生情况。 结果 钬激光组手术时间较长(P<0.05)，但术中出血量(55.54±36.21)mL、膀胱冲洗时间(15.58±3.21)h，均低于电切组(P<0.05)；钬激光组切除组织量(53.23±15.84)g，多于电切组(P<0.05)。 术后3个月IPSS、QoL评分、残余尿量(PVR)及并发症差异无统计学意义(P>0.05)，钬激光组的最大尿流率Qmax(18.38±5.21)mL/s，优于电切组(P<0.05)。 结论 经尿道钬激光剜除术治疗前列腺增生，安全、有效、创伤小，前列腺组织切除彻底，具有推广价值。
[关键词] 良性前列腺增生；汽化电切术；钬激光剜除术
[中图分类号] R699 [文献标识码] A [文章编号] 1674-0742(2018)08(a)-0036-04
Transurethral Holmium Laser Ablation and Plasma Resection for Benign Prostatic Hyperplasia
LIN Ning-feng， LIU Chang-ming， WENG Wu-bin
Department of Urology， Mindong Hospital， Fujian Medical University， Fuan， Fujian Province， 355000 China
[Abstract] Objective To compare the efficacy of transurethral holmium laser enucleation of the prostate (HOLEP) and plasma resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH). Methods 60 patients with BPH admitted to the hospital from January to December in 2017 were convenient selected and randomized into two groups. 30 patients in each group were treated with HOLEP or PKRP. The intraoperative conditions， postoperative efficacy， and complications were compared between the two groups. Results The holmium laser group had a longer operation time(P<0.05)， but the intraoperative blood loss (55.54±36.21)mL and bladder irrigation time(15.58±3.21) h were lower than that of the TUR group(P<0.05). The amount of tissue (53.23±15.84)g was more than that of the transection group (P<0.05). There were no significant differences in IPSS， QoL scores， residual urine volume(PVR) and complications after 3 months(P>0.05). The maximum urinary flow rate Qmax (18.38±5.21)mL/s in the He-Ne laser group was superior to that of the TUR group(P<0.05). Conclusion Transurethral holmium laser ablation for the treatment of benign prostatic hyperplasia is safe， effective， minimally invasive， and the prostate tissue is removed completely.
[Key words] Benign prostatic hyperplasia； Vaporization resection technique； Holmium laser ablation
良性前列腺增生(BPH ) 是老年男性常见的疾病，经尿道等离子前列腺电切术(PKRP)治疗BPH安全可靠，被广泛开展[1]。近来年经尿道钬激光前列腺剜除术(holmium laser enucleationof the prostate，HOLEP) 发展迅速，有成为治疗BPH 金标准之趋势[2-3]。
该院泌尿外科2017年1—12月收治行手术治疗的良性前列腺增生患者60例，随機分为两组，分别行保留部分尿道粘膜的经尿道钬激光前列腺剜除术(HOLEP)和经尿道等离子前列腺电切术(PKRP)，进行比较研究，现报道如下。
1 资料与方法
1.1 一般资料
方便选取60例BPH患者均符合入组标准：详细询问其病史，具备较明显的尿频、尿急、排尿困难以致尿潴留；术前临床诊断良性前列腺增生；术前经尿动力检查符合膀胱出口梗阻，并排除糖尿病、帕金森、脑血管疾病等所致逼尿肌收缩无力、神经源性膀胱；术前有尿道感染者，经抗感染治疗3～5 d，复查尿沉渣正常；术前服用阿司匹林、华法林等抗凝药物，停药7 d以上；术前高血压、高血糖者，进行有效药物治疗后。经患者及家属同意，符合伦理学标准。, http://www.100md.com(林宁峰 刘昌明 翁吴斌)
[关键词] 良性前列腺增生；汽化电切术；钬激光剜除术
[中图分类号] R699 [文献标识码] A [文章编号] 1674-0742(2018)08(a)-0036-04
Transurethral Holmium Laser Ablation and Plasma Resection for Benign Prostatic Hyperplasia
LIN Ning-feng， LIU Chang-ming， WENG Wu-bin
Department of Urology， Mindong Hospital， Fujian Medical University， Fuan， Fujian Province， 355000 China
[Abstract] Objective To compare the efficacy of transurethral holmium laser enucleation of the prostate (HOLEP) and plasma resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH). Methods 60 patients with BPH admitted to the hospital from January to December in 2017 were convenient selected and randomized into two groups. 30 patients in each group were treated with HOLEP or PKRP. The intraoperative conditions， postoperative efficacy， and complications were compared between the two groups. Results The holmium laser group had a longer operation time(P<0.05)， but the intraoperative blood loss (55.54±36.21)mL and bladder irrigation time(15.58±3.21) h were lower than that of the TUR group(P<0.05). The amount of tissue (53.23±15.84)g was more than that of the transection group (P<0.05). There were no significant differences in IPSS， QoL scores， residual urine volume(PVR) and complications after 3 months(P>0.05). The maximum urinary flow rate Qmax (18.38±5.21)mL/s in the He-Ne laser group was superior to that of the TUR group(P<0.05). Conclusion Transurethral holmium laser ablation for the treatment of benign prostatic hyperplasia is safe， effective， minimally invasive， and the prostate tissue is removed completely.
[Key words] Benign prostatic hyperplasia； Vaporization resection technique； Holmium laser ablation
良性前列腺增生(BPH ) 是老年男性常见的疾病，经尿道等离子前列腺电切术(PKRP)治疗BPH安全可靠，被广泛开展[1]。近来年经尿道钬激光前列腺剜除术(holmium laser enucleationof the prostate，HOLEP) 发展迅速，有成为治疗BPH 金标准之趋势[2-3]。
该院泌尿外科2017年1—12月收治行手术治疗的良性前列腺增生患者60例，随機分为两组，分别行保留部分尿道粘膜的经尿道钬激光前列腺剜除术(HOLEP)和经尿道等离子前列腺电切术(PKRP)，进行比较研究，现报道如下。
1 资料与方法
1.1 一般资料
方便选取60例BPH患者均符合入组标准：详细询问其病史，具备较明显的尿频、尿急、排尿困难以致尿潴留；术前临床诊断良性前列腺增生；术前经尿动力检查符合膀胱出口梗阻，并排除糖尿病、帕金森、脑血管疾病等所致逼尿肌收缩无力、神经源性膀胱；术前有尿道感染者，经抗感染治疗3～5 d，复查尿沉渣正常；术前服用阿司匹林、华法林等抗凝药物，停药7 d以上；术前高血压、高血糖者，进行有效药物治疗后。经患者及家属同意，符合伦理学标准。, http://www.100md.com(林宁峰 刘昌明 翁吴斌)