经尿道钬激光前列腺剜除术与前列腺电切术近期疗效的对比分析

目的比较前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)和前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生(benign prostatic hyplasia,BPH)的疗效及安全性。方法将2012年6月至2013年7月90例行腔内手术治疗的BPH患者随机分为2组,分别行前列腺钬激光剜除术(HoLEP)和经尿道前列腺电切术(TURP)。监测、记录2组患者围手术期和术后1、3、6个月复查指标,比较最大尿流率(maximum flow rate,Qmax)、国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(quality of life score,QOL)等变化并进行统计学分析,比较两种术式近期临床疗效。结果术前两组患者一般情况和国际前列腺症状评分、生活质量评分、最大尿流率、残余尿量测量以及前列腺重量比较差异无统计学意义(P0.05);HoLEP组较TURP组术中出血量、手术时间、低钠血症的发生率、膀胱冲洗时间、留管时间都较低(P0.01);术后1个月、3个月及6个月2组IPSS、QOL和Qmax均比术前有明显改善(P0.01);但2组间比较并无显著统计学意义(P0.05)。结论 HoLEP术与TURP术相比,近期手术效果相似,且手术安全性更好,可视为治疗BPH的较好新方法。

Comparative analysis of holmium laser enucleation of prostatic and transurethral resection of prostate in the treatment of benign prostatic hyperplasia

Objective To Compare the efficacy and safety of holmium laser enucleation of the prostate （HoLEP） and transurethral resection of the prostate （TURP） in the treatment of benign prostatic hyperplasia （BPH）. Methods During June 2012 to July 2013, 90 BPH patients to undergo regular cavity surgical treatment were randomly divided into the HoLEP group （n= 45） and TURP group （n = 45）. The perioperative and postoperative indexes after 1 month, 3 months and 6 months were recorded and reviewed. The maximum urinary flow rate （Qmax）, international prostate symptom score （IPSS）, quality of life score （QOL）, and other changes were statistically analyzed. Results Preoperative general situation was similar between the two groups, with no statistical significance （P〉0.05）. After 1 month, 3 months and 6 months, IPSS, QOL and Qmax of both groups were significantly improved （P〈0.01）. Intraoperative blood loss, transurethral resection syndrome （TURS） incidence, the average postoperative bladder irrigation time, catheter time and length of hospital stay of the HoLEP group were significantly less than those of the TURP group （P〈0.01）. Conclusion Compared with TURP surgery, HoLEP surgery produces similar therapeutic effects but is safer. It can serve as a new therapeutic approach for BPH.