摘要
目的:探讨全逆时针两叶法铥激光前列腺剜除术治疗良性前列腺增生(BPH)的疗效及安全性.方法:回顾性分析 2020年至 2022年 95例行经尿道前列腺手术的BPH患者的临床资料.依术式不同将其分为两组,其中全逆时针两叶法铥激光前列腺剜除术组47例,经尿道前列腺电切术(TURP)组48例.通过比较两组手术时间、术中出血量、前列腺切除量、术中并发症、血红蛋白下降值、术后留置尿管时间、术后持续膀胱冲洗时间、术后住院时间、术后短期并发症、术后晚期并发症及术后 3个月最大尿流率、残余尿量、国际前列腺症状评分(IPSS)、生活质量评分(QoL)来分析该术式的疗效和安全性,统计学方法采用两独立样本t检验、Mann-Whiteny U检验、配对样本t检验及卡方检验.结果:全逆时针两叶法铥激光前列腺剜除术组在手术时间、前列腺切除量、手术出血量、血红蛋白下降值、术后留置尿管、术后持续膀胱冲洗时间、术后住院时间及术后 3个月QoL评分优于TURP组,差异均有统计学意义(P均<0.05).两组患者术后短期并发症、晚期并发症及术后 3个月Qmax、PVR、IPSS比较差异无统计学意义(P均>0.05).结论:全逆时针两叶法铥激光前列腺剜除术较TURP具有手术时间短、手术效率高、出血少、恢复快等优点,疗效好,安全性高,值得在临床推广.
Abstract
Objective:To evaluate the efficacy and safety of the full counterclockwise two-lobe thulium laser prostate enucleation(TmLPE)in the treatment of benign prostatic hyperplasia(BPH).Methods:A retrospective analysis was conducted on the clinical data of 95 BPH patients who underwent transurethral prostate surgery between 2020 and 2022.The patients were divided into two groups based on the surgical technique used:47 patients in the full counterclockwise two-lobe TmLPE group and 48 patients in the transurethral resection of the prostate(TURP)group.The surgical time,intraoperative blood loss,prostate tissue resected,intraoperative complications,decrease in hemoglobin levels,postoperative catheter retention time,duration of bladder irrigation,length of hospital stay,short-term and long-term postoperative complications,as well as the maximum urine flow rate(Qmax),post-void re-sidual(PVR),International Prostate Symptom Score(IPSS),and Quality of Life(QoL)scores at 3 months postop-eratively were compared to assess the efficacy and safety of the two surgical techniques.Statistical analysis was per-formed using independent samples t-test,Mann-Whitney U test,paired t-test,and chi-squared test.Results:The full counterclockwise two-lobe TmLPE group showed significantly shorter surgical time,greater prostate tissue re-moval,lower surgical blood loss,smaller decrease in hemoglobin levels,shorter catheter retention time,shorter blad-der irrigation time,shorter hospital stay,and better QoL at 3 months postoperatively compared to the TURP group(P<0.05 for all).There were no significant differences between the two groups in terms of short-term complica-tions,long-term complications,Qmax,PVR,and IPSS at 3 months postoperatively(P>0.05 for all).Conclu-sion:The full counterclockwise two-lobe TmLPE offers advantages over TURP,including shorter surgical time,higher surgical efficiency,less bleeding,and faster recovery.It demonstrates good efficacy and high safety,making it a promising technique for clinical application.
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