经尿道前列腺钬激光剜除术治疗良性前列腺增生的疗效研究

目的：观察经尿道前列腺钬激光剜除术（holmiumlaserenucleationoftheprostate，HoLEP）治疗良性前列腺增生的临床疗效及安全性。方法应用100W钬激光和组织粉碎器对480位良性前列腺增生症的患者行经尿道钬激光前列腺剜除术和组织粉碎术。分别记录患者术前、术中及术后随访的临床资料，分析及评估HoLEP的疗效及安全性。结果480例手术均成功，手术时间25～240min，平均（76．1±39．2）min，切除腺体15～320g，平均（45．8±15．4）g。术后留置导尿48～216h，平均（72．5±23．2）h，术后膀胱持续冲洗时间0～48h，平均（23．6士11．2）h，术后住院时间3～15d，平均（3．36±1．25）d，血红蛋白平均降低（1．1±0．5）g／dL。术后IPSS、QOL、Qmax、PVR较术前明显改善（P〈0．01）。术后并发症率低。结论经尿道前列腺钬激光剜除治疗良性前列腺增生疗效安全可靠，并发症少，剜除彻底，并且适应范围广，有可能挑战TURP成为治疗BPH的新的金标准。

A study of the outcomes of holmium laser enucleation of the prostate for patients with benign prostatic hyperplasia

Objective To evaluate the outcomes and safety of holmium laser enucleation of the prostate （HoLEP） in pa- tients with benign prostate hyperplasia （BPH）. Methods A total of 480 BPH patients were treated successfully by 100 W HoLEP and morcellation equipment. The preoperative, perioperative, postoperative and follow-up data were recorded to evaluate the outcomes and safety of the surgery. Results All operations were successful. The operations time was 25-240 min, averaging （76.1 ± 39.2） min. The removed glands weighed 15 - 320 g, averaging （45.8 ± 15.4） g. Catheterization time was 48- 216 h, averaging （72.5±23.2）h. Bladder irrigation time was 0-48 h, averaging （23.6±11.2）h. Hospital stay was 3-15 d, averaging （3.36 ±1.25）d. Haemoglobin decreased by an average of （1.1 ± 0.5）g/dL. All cases displayed significant improvements in IPSS, QOL, Qmax and PVR （P〈0. 01） after surgery, and postoperative complication rate was low. Oonclusions HoLEP is a safe and effective procedure with low complication rate, more removal of the prostate and a wide range of application. It should be proposed as a potential surgical therapy challenging transurethral resection of the prostate for patients with benign prostatic hyperplasia.