经尿道摩西钬激光前列腺剜除术治疗良性前列腺增生的临床研究

目的探讨经尿道摩西钬激光前列腺剜除术在良性前列腺增生(BPH)患者中的应用效果,旨在为BPH患者快速康复提供更好的手术治疗方案。方法应用前瞻性随机双盲对照研究法,选取2018年8月至2019年11月在本院住院的80例BPH患者作为研究对象,将其随机分为两组,对照组(40例)采用经尿道100 W钬激光前列腺剜除术,研究组(40例)采用经尿道摩西钬激光前列腺剜除术,手术均由同一医师完成,术式为改良钬激光前列腺剜除术(三叶十七步法);比较两组的前列腺剜除时间、术中出血量、术后3 h血清钠下降程度、术后拔除尿管时间、住院时间,统计两组患者术前、术后3个月的最大尿流率(Qmax)、残余尿量(PVR)、国际前列腺症状评分(IPSS),观察学习曲线等指标。结果研究组的前列腺剜除时间、术中出血量、术后拔除尿管时间、住院时间比较差异有统计学意义(P<0.05),两组患者手术前后的血清钠变化差异无统计学意义(P>0.05);两组术后3个月的Qmax、PVR、IPSS均较治疗前显著改善(P<0.05),但术后组间比较差异无统计学意义(P>0.05);两组患者术中均无膀胱损伤及TUR综合征患者,无输血患者,无术后尿道外口狭窄患者,术后均无严重并发症;学习曲线方面,经尿道摩西钬激光前列腺剜除术的学习曲线较短。结论经尿道摩西钬激光前列腺剜除术安全性高、风险较小、疗效良好、术后康复快,且学习曲线较短,表现出较高的临床应用价值。

Clinical study of transurethral moses holmium laser prostatectomy for benign prostatic hyperplasia

Objective To investigate the application effect of transurethral HoLEP holmium laser prostatectomy in patients with benign prostatic hyperplasia(BPH),in order to provide a better surgical treatment for patients with benign prostatic hyperplasia.Methods Application prospective,randomized,double-blind controlled study method,the selection between August 2018 and November 2019 hospitalized in our hospital 80 cases of BPH patients as the research object,which were randomly divided into two groups,control group(40 cases)by transurethral holmium laser of 100 W prostate gouge out in addition to surgery,group(40 cases)by transurethral holmium laser Moses prostate gouge out in addition to surgery,all operations were completed by the same physician,modified HoLEP procedure for surgery(17,3 leaf footwork).The maximum urine flow rate(Qmax),residual urine volume(PVR)and international prostate symptom score(IPSS)before and 3 months after surgery were calculated,and the learning curve was observed.Results There were statistically significant differences in the time of prostate enucleation,intraoperative blood loss,postoperative catheter removal time and hospital stay in the study group(P<0.05).There was no statistically significant difference in serum sodium before and after surgery in the two groups(P>0.05).The Qmax,PVR and IPSS of the two groups were significantly improved 3 months after operation compared with those before treatment(P<0.05),but there was no statistically significant difference between the two groups after operation(P>0.05).There were no patients with bladder injury and TUR syndrome,no patients with blood transfusion,no patients with postoperative urethral stricture,and no serious postoperative complications in the two groups.In terms of learning curve,the learning curve of transurethral holmium laser prostatectomy was shorter.Conclusions Transurethral Moses holmium laser prostatectomy has high safety,low risk,good efficacy,quick postoperative recovery,and short learning curve,showing high clinical application value.