经尿道刀口变向钬激光前列腺剜除术与经尿道双极等离子前列腺剜除术治疗良性前列腺增生的疗效比较

目的比较经尿道刀口变向钬激光前列腺剜除术(THoLEP)与经尿道双极等离子前列腺剜除术(PKERP)治疗良性前列腺增生(BPH)的疗效。方法回顾性分析2016年9月至2018年9月收治的80例BPH患者,分为THoLEP组和PKERP组,对比分析两组患者的围手术期指标(手术时间、前列腺切除质量、术前后血红蛋白减少量.膀胱冲洗时间.导尿管留置时间、住院时间、手术并发症)和术后3个月复查指标国际前列腺症状评分(IPSS)、生活质量评分(Q0L)、最大尿流率(Q^max)、残余尿量(RUV)、术后尿失禁症状发生率]并进行统计学分析。结果THoLEP组的手术时间、术后血红蛋白下降量、膀胱冲洗时间.导尿管留置时间、住院时间等方面均少于PKERP组,差异有统计学意义(P<0.05);两组术后的IPSS、Q0L、PVR均低于术前,而术后Q^max高于术前,差异有统计学意义(P<0.05),但术后两组间比较,差异无统计学意义(P>0.05);两组均未出现穿孔、大出血.水中毒等并发症;THoLEP组术后尿失禁并发症发生率少于PKERP组,差异无统计学意义(P>0.05)。结论THoLEP和PKERP治疗BPH临床疗效相当,但THoLEP术中出血少、膀胱冲洗时间、导尿管留置时间、住院时间短.术后尿失禁发生率低于PKERP,临床值得推广。

Comparison of efficacy between turning holmium laser enucleation of the prostate and transurethral bipolar plasmakinetic enucleation and resection of the prostate in the treatment of benign prostatic hyperplasia

Objective To compare the clinical efficacy btHween turning holmium laser enucleation of the prostate(THoLEP)and transurethral bipolar plasmakinetic enucleation and resection of the prostate(PKERP)in the treatment of benign prostatic hyperplasia(BPH).Methods A retrospective analysis of 80 patients who were diagnosed BPH were divided into THoLEP group and PKERP group.The perioperative(operation time,gland weight,hemoglobin loss,bladder irrigation time,catheter indwelling time,time of hospital stay,surgical complications)and postoperative indexesinternational prostate symptom score(IPSS),quality of life score(QOL),maximal urinary flow rate(Qniax),residual urine volume(RUV)and postoperative urinary incontinence]after 3 months were recorded and analyzed.Results There were no significance differences in preoperative factors between the two groups(P>0.05).The operation time(62.60±11.36)min,hemoglobin loss(9.87±6.56)g/L,the mean bladder irrigating time(18.5±4.2)h,catheter indwelling time(48.0±3.6)h,hand hospital stay time(5.89±1.25)days in THoLEP were shorter or less than those in PKERP(P<0.05).After 3 m onths,PV R,IPSS,Q max and QOL were both significantly improved(P<0.05),but the differences between the two groups were not significant(P>0.05).There were no complications such as perforation,massive hemorrhage and water poisoning in both groups.The postoperative urinary incontinence in THoLEP were less than those in PKERP(P>0.05).Conclusions THoLEP and PKERP have the same curative effect in the treatment of BPH,but the former is more security with fewer complications.THoLEP is worthy of widely application.