摘要
目的 比较铥激光前列腺剜除术(ThuLEP)与等离子前列腺剜除术(PKEP)治疗大体积(≥80 mL)良性前列腺增生(BPH)的近期疗效,评估两种手术方法的优劣,为临床选择BPH治疗方法提供参考.方法 回顾性分析2021年6月—2023年6月于山东大学附属山东省立第三医院泌尿外科收治的100例大体积BPH患者的临床资料,根据手术方式不同分为两组,其中采用ThuLEP治疗的患者归于ThuLEP组(n=50),采用PKEP治疗的患者归于PKEP组(n=50).比较两组患者的手术时间、术中出血量、剜除前列腺组织重量、术后膀胱冲洗时间、术后留置导尿管时间、术后住院时间及并发症发生率.比较两组患者术前及术后3个月的国际前列腺症状评分(IPSS)、生活质量评分(QoL)及最大尿流率(Qmax)变化情况.结果 ThuLEP组和PKEP组患者的手术时间[(79.04±9.42)min vs.(80.10±8.94)min]、术中出血量[(42.86±7.84)mL vs.(43.32±7.36)mL]及术后膀胱冲洗时间[(19.88±4.13)h vs.(20.10±4.04)h]比较,差异均无统计学意义(P＞0.05);ThuLEP组剜除前列腺组织重量大于PKEP 组[(69.44±4.90)g vs.(65.06±5.25)g],术后留置导尿管时间及住院时间均短于 PKEP 组[(27.20±4.07)h vs.(29.02±4.86)h;(3.30±0.66)d vs.(4.05±0.91)d],差异均有统计学意义(P＜0.05).与术前比较,术后3个月ThuLEP组和PKEP组患者的IPSS、QoL及Qmax均有明显改善(P＜0.05),但组间比较差异无统计学意义(P＞0.05).ThuLEP组和PKEP组并发症发生率的差异无统计学意义(2％ws.4％,P＞0.05).结论 ThuLEP与PKEP治疗大体积BPH均有较好的近期疗效及安全性,但ThuLEP在剜除增生的前列腺组织、缩短术后留置导尿管时间及住院时间方面均优于PKEP.
Abstract
Objective To compare the short-term outcomes of thulium laser enucleation of the prostate(ThuLEP)and plasmaknife enucleation of the prostate(PKEP)in the treatment of large volume(≥80 mL)benign prostatic hyperplasia(BPH),so as to provide reference for clinical practice.Methods Clinical data of 100 patients with large volume BPH admitted to the Shandong Provincial Third Hospital affiliated with Shandong University during Jun.2021 and Jun.2023 were retrospectively analyzed.Based on the surgical methods,patients were divided into the ThuLEP group(n=50)and PKEP group(n=50).The following parameters were compared between the two groups,including preoperative maximum flow rate(Qmax),international prostatic symptom score(IPSS),quality of life score(QoL),operation time,intraoperative blood loss,weight of enucleated prostate tissue,postoperative bladder irrigation time,catheterization time,hospital stay,complication rate,and postoperative Qmax,IPSS,and QoL at 3 months.Results The operation time[(79.04±9.42)min vs.(80.10±8.94)min],intraoperative blood loss[(42.86±7.84)mL vs.(43.32±7.36)mL],and postoperative continuous bladder irrigation time[(19.88±4.13)h vs.(20.10±4.04)h]were not statistically different between the ThuLEP and PKEP groups(P＞0.05).The weight of enucleated tissue during ThuLEP was higher than that during PKEP[(69.44±4.90)g vs.(65.06±5.25)g],postoperative catheterization time was shorter[(27.20±4.07)h vs.(29.02±4.86)h],and hospital stay was shorter[(3.30±0.66)d vs.(4.05±0.91)d],with statistically significant differences(P＜0.05).Three months after operation,the Qmax,IPSS,and QoL score in both groups were significantly improved(P＜0.05),but there were no statistically significant differences between the two groups(P＞0.05).There was no statistically significant difference in the complication rate between the ThuLEP and PKEP groups(2％vs.4％,P＞0.05).Conclusion Both ThuLEP and PKEP have good short-term efficacy and safety in the treatment of large volume BPH,but ThuLEP is superior to PKEP in terms of reducing enucleated prostate weight,and shortening postoperative catheterization time and hospital stay.
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