中国中西医结合外科杂志2024，Vol.30Issue(3) ：372-376.DOI:10.3969/j.issn.1007-6948.2024.00.016

钬激光前列腺剜除术与等离子电切术治疗良性前列腺增生的疗效及安全性比较

Comparison of efficacy and safety of holmium laser enucleation of prostate and plasmakinetic resection of prostate in treating benign prostatic hyperplasia

刘镇 于世翠 栾杰 张博文 王伟 史本康
中国中西医结合外科杂志2024，Vol.30Issue(3) ：372-376.DOI:10.3969/j.issn.1007-6948.2024.00.016
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钬激光前列腺剜除术与等离子电切术治疗良性前列腺增生的疗效及安全性比较

Comparison of efficacy and safety of holmium laser enucleation of prostate and plasmakinetic resection of prostate in treating benign prostatic hyperplasia

刘镇 1于世翠 1栾杰 1张博文 1王伟 1史本康2
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作者信息

  • 1. 青岛市胶州中心医院泌尿外科(青岛 266300)
  • 2. 山东大学齐鲁医院泌尿外科(济南 250012)
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摘要

目的:对比钬激光前列腺剜除术(HoLEP)与等离子电切术(PKRP)治疗良性前列腺增生(BPH)的效果及安全性.方法:前瞻性选取2020年1月-2023年1月我院收治的138例BPH患者,按随机数字表法分为HoLEP组和PKRP组,每组69例,对比两组围术期相关指标、前列腺症状、生活质量、排尿功能、勃起功能、射精功能及术后并发症发生情况.结果:与PKRP组比较,HoLEP组手术时间较长,术中出血量较少,切除腺体重量较重,术后膀胱冲洗时间、导尿管留置时间及住院时间均较短(P＜0.05).术后3个月时,相较于PKRP组,HoLEP组的国际前列腺症状评分法(IPSS)、生活质量指数(QOL)得分较低(P＜0.05),最大尿流率(Qmax)、平均尿流率(Qave)均较高(P＜0.05),残余尿量(RUV)较少(P＜0.05);HoLEP组的国际勃起功能指数(IIEF)-5评分、男性性健康问卷-射精功能障碍评分(MSHQ-EjD)量表中的射精功能评分均较高(P＜0.05).HoLEP组和PKRP组术后并发症发生率无统计学差异(P＞0.05).结论:相较于PKRP,HoLEP治疗BPH更具优势,手术创伤更小,术后前列腺症状及排尿功能改善更佳,且对患者勃起功能及射精功能的影响更小.

Abstract

Objective To compare the therapeutic effect of holmium laser enucleation of the prostate(HoLEP)and plasmakinetic resection of prostate(PKRP)in the treatment of benign prostatic hyperplasia(BPH).Methods 138 patients with BPH in our hospital from January 2020 to January 2023 were prospectively selected and divided into HoLEP group and PKRP group by means of the random number table method,with 69 cases in each group.The perioperative related indicators,prostate symptoms,quality of life,urinary function,erectile function,ejaculatory function and occurrence of postoperative complications were compared.Results Compared with PKRP group,the surgical time in HoLEP group was longer,the intraoperative blood loss was less,the weight of resected gland was heavier,and the postoperative bladder irrigation time,urinary catheter indwelling time and hospital stay were shorter(P＜0.05).At 3 months after surgery,the International Prostate Symptom Score(IPSS)and Quality of Life Index(QOL)score were lower in HoLEP group than those in PKRP group(P＜0.05),and the maximum urinary flow rate(Qmax)and average urinary flow rate(Qave)were higher(P＜0.05)and the residual urine volume(RUV)was less(P＜0.05).The IIEF-5 score and ejaculatory function score of Male Sexual Health Questionnaire-Ejaculatory Dysfunction Scale(MSHQ-EjD)in HoLEP group were higher(P＜0.05).The incidence rates of postoperative complications were comparable between HoLEP group and PKRP group(P＞0.05).Conclusion Compared with PKRP,HoLEP has more advantages in the treatment of BPH,with smaller surgical trauma,better improvement of postoperative prostate symptoms and urinary function,and less impact on erectile function and ejaculatory function.

关键词

良性前列腺增生/钬激光前列腺剜除术/等离子电切除术/排尿功能

Key words

Benign prostatic hyperplasia/holmium laser enucleation of the prostate/plasmakinetic resection of prostate/urinary function

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基金项目

国家自然科学基金(82170790)

出版年

2024
中国中西医结合外科杂志
中国中西医结合学会 天津市中西医结合急腹症研究所

中国中西医结合外科杂志

CSTPCD
影响因子：0.918
ISSN：1007-6948
参考文献量8
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