前列腺钬激光整块剜除术与经尿道前列腺电切术治疗前列腺增生的比较

目的对比前列腺钬激光整块剜除术（HoLEP）与经尿道前列腺电切术（TURP）在治疗前列腺增生（BPH）中的疗效。 方法行前瞻性研究，将医院2018年6月至2021年6月收治的76例BPH患者纳为研究对象，随机数字表法将其均分为HoLEP组及TURP组，比较两组围术期相关指标及术后恢复指标，探究两种术式在治疗BPH中的疗效。 结果HoLEP组手术时间较TURP组延长，血红蛋白下降值较TURP组低，前列腺切除重量较TURP组增加，差异均具有统计学意义（P<0.05）。HoLEP组手术前后电解质Na⁺及K⁺水平比较，差异均无统计学意义（P>0.05），TURP组术后Na⁺及K⁺水平较其术前均下降，且其术后Na⁺及K⁺水平均低于HoLEP组术后水平，差异均具有统计学意义（P<0.05）。HoLEP组术后膀胱冲洗时间、留置导尿管时间及术后住院时间均短于TURP组，差异具有统计学意义（P<0.05）。HoLEP组术后并发症发生率低于TURP组，差异具有统计学意义（P<0.05）。术后6个月，两组国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Q_max）、残余尿以及最大尿流率时逼尿肌压力（Pdet/Q_max）水平比较，差异均无统计学意义（P>0.05）。 结论HoLEP及TURP均能有效切除增生前列腺组织，改善BPH患者下尿路症状，实现治疗目的，但与TURP相比，HoLEP术后并发症更少，患者术后恢复更快。

Comparison of the clinical efficacy of holmium laser enucleation and transurethral resection of the prostate for benign prostatic hyperplasia

ObjectiveTo compare the clinical efficacy of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). MethodsSeventy-six patients with BPH admitted to our hospital from June 2018 to June 2021 were prospectively enrolled, and were divided into HoLEP group and TURP group by random number table method. Perioperative related indicators and postoperative recovery indicators were compared to explore the clinical efficacy of two surgical procedures in the treatment of BPH. ResultsCompared with TURP group, HoLEP group had significantly longer operation time, less decrease of hemoglobin, and more prostate resection weight, with statistical differences (P<0.05). After surgery, electrolyte Na⁺ and K⁺ levels had no significant changes in HoLEP group (P>0.05), while were significantly decreased in TURP group (P<0.05), and the postoperative Na⁺ and K⁺ levels were significantly lower in TURP group than in HoLEP group (P<0.05). The bladder flushing time, indwelling catheter time and postoperative hospital stay length in HoLEP group were shorter than those in TURP group (P<0.05). The incidence of postoperative complications in HoLEP group was lower than that in TURP group (P<0.05). The international prostate symptom score (IPSS), quality of life score (QOL), maximum flow rate (Q_max), residual urine and Pdet/Q_max at postoperative 6 months showed no statistical difference between two groups (P>0.05). ConclusionBoth HOLEP and TURP can effectively remove hyperplastic prostate tissue and improve the lower urinary tract symptoms of BPH patients, but compared with TURP, HOLEP has the advantages of fewer postoperative complications and faster postoperative recovery.