首页|不同功率HoLEP联合钬激光碎石术在治疗良性前列腺增生合并膀胱结石的疗效及安全性分析

不同功率HoLEP联合钬激光碎石术在治疗良性前列腺增生合并膀胱结石的疗效及安全性分析

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目的:研究不同功率钬激光前列腺剜除术(HoLEP)联合钬激光碎石术(HLC)在治疗良性前列腺增生(BPH)合并膀胱结石的疗效及安全性分析。方法:收集 2019 年 1 月至 2024 年 1 月丹阳市人民医院收治的110 例BPH合并膀胱结石患者的临床资料，根据手术方式，将接受高功率HoLEP 联合HLC的患者纳入HP 组(n=62)，接受低功率HoLEP 联合HLC的患者纳入LP 组(n=48)。比较两组围术期指标、排尿功能、应激指标、术后并发症。结果:HP 组手术时间(68。49±15。36)min、剜除组织质量(41。42±10。59)g、膀胱冲洗时间(1。86±0。66)d、术后尿管留置时间(2。34±0。85)d与LP 组[(70。15±15。71)min、(42。81±9。93)g、(1。81±0。72)d、(2。58±0。92)d]比较差异无统计学意义(P>0。05);HP 组腺体剜除时间(35。80±7。21)min、住院时间(3。62±0。64)d 短于 LP 组[(41。64±7。83)min、(3。86±0。50)d]，剜除效率(1。15±0。25)g/min、血红蛋白下降幅度(8。05±1。58)g/L 高于 LP 组[(1。02±0。18)g/min、(7。36±1。72)g/L]，差异有统计学意义(P<0。05);术后3 个月，HP 组Qmax、PVR、PSA治疗前后差值与LP 组比较差异无统计学意义(P>0。05);术后 24h，HP 组 SP、PGE2、NE 治疗前后差值与 LP 组比较差异无统计学意义(P>0。05);HP 组术后并发症(12。88%)与LP 组(10。40%)比较，差异无统计学意义(P>0。05)。结论:高功率、低功率 HoLEP 联合 HLC 对 BPH 合并膀胱结石的疗效相当，高功率 Ho-LEP 剜除效率更高，腺体剜除时间、住院时间更短，低功率HoLEP 的止血效果更好。
Efficacy and Safety Analysis of Different Power HoLEP Combined with Holmium Laser Lithotripsy in the Treatment of Benign Prostatic Hyperplasia with Bladder Stones
Objective:To study the efficacy and safety of different powers of holmium laser enucleation of the prostate(HoLEP)combined with holmium laser cystolithotripsy(HLC)in the treatment of benign pros-tatic hyperplasia(BPH)with bladder stones.Methods:The clinical data of 110 patients with BPH combined with bladder stones admitted to Danyang People's Hospital from January 2019 to January 2024 were collected.According to the surgical methods,patients who received high-power HoLEP combined with HLC were includ-ed in the HP group(n=62),and patients who adopted low-power HoLEP combined with HLC were enrolled as the LP group(n=48).Perioperative indicators,urinary function,stress indicators,and postoperative complications were compared between both groups.Results:The surgical time,excised tissue mass,bladder irrigation time and postoperative urinary catheter retention time with(68.49±15.36)min,(41.42±10.59)g(1.86±0.66)d and(2.34±0.85)d in the HP group were not statistically different form(70.15±15.71)min,(42.81±9.93)g,(1.81±0.72)d and(2.58±0.92)d in the LP group(P>0.05).The time of glan-dular enucleation and hospital stay with(35.80±7.21)min and(3.62±0.64)d in the HP group were shor-ter than(41.64±7.83)min and(3.86±0.50)d in the LP group,and the enucleation efficiency and de-crease rate of hemoglobin with(1.15±0.25)g/min and(8.05±1.58)g/L were higher than(1.02±0.18)g/min and(7.36±1.72)g/L in the LP group(P<0.05).At 3 months after surgery,the differences of Qmax,PVR and PSA before and after treatment were not statistically significant between the HP group and the LP group(P>0.05).The differences of SP,PGE2 and NE before and after treatment revealed no statistical differences between the HP group and the LP group at 24 hours after surgery(P>0.05).There was no statis-tical significance in incidence of postoperative complications between the HP group(12.88%)and the LP group(10.40%)(P>0.05).Conclusion:High-power and low-power HoLEP combined with HLC have similar efficacy in the treatment of BPH with bladder stones.High-power HoLEP has higher enucleation effi-ciency,and shorter glandular enucleation time and hospital stay,and low-power HoLEP has better hemostatic effect.

Low-power holmium laser enucleation of the prostateHigh-power holmium laser enu-cleation of the prostateHolmium laser cystolithotripsyBenign prostatic hyperplasiaBladder stones

夏东东、曾明辉、秦锁炳、蒋东方

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江苏省丹阳市人民医院泌尿外科,江苏 丹阳 212300

低功率钬激光前列腺剜除术 高功率钬激光前列腺剜除术 钬激光碎石术 良性前列腺增生 膀胱结石

江苏省卫生健康卫2023年度医学科研立项项目

H2023042

2024

10.3969/j.issn.1006-6233.2024.10.018

河北医学
河北省医学会

河北医学

CSTPCD
影响因子：1.915
ISSN：1006-6233
年,卷(期)：2024.30(10)