摘要
目的:探讨前列腺铥激光剜除术(ThuLEP)与等离子电切术(PKRP)治疗良性前列腺增生(BPH)的对比研究.方法:回顾性研究本院2021 年1 月至2023 年12 月收治的160 例BPH患者病历资料,根据手术方式的不同将患者分为观察组(n=80)和对照组(n=80).对照组实施PKRP治疗,观察组实施ThuLEP治疗.比较两组的手术时间、膀胱冲洗时间、导管留置时间、住院时间,并比较两组术前、术后 3 个月的最大尿流速(Qmax)、残余尿量(PVR)、前列腺特异性抗原(PSA)、前列腺体积的变化情况和术后并发症.结果:观察组的手术时间、膀胱冲洗时间、导管留置时间、住院时间[(60.10±5.15)min、(43.24±6.65)h、(5.03±1.24)d、(6.55±1.67)d]均短于对照组[(67.25±7.24)min、(46.90±10.77)h、(5.60±1.31)d、(7.31±2.00)d,P<0.05)];观察组术后3 个月的Qmax水平[(20.68±1.45)ml/s]高于对照组[(18.50±1.24)ml/s],PVR、PSA、前列腺体积水平[(10.82±3.10)ml、(3.38±0.40)μg/L、(20.12±5.13)ml]均低于对照组[(12.10±3.53)ml、(4.60±0.78)μg/L、(25.35±6.46)ml,P<0.05)];两组术后并发症的总发生率(7.50%vs 5.00%),无统计学意义(P>0.05).结论:ThuLEP治疗BPH具有显著疗效,能够缩减手术及住院时长,改善尿流动力学和前列腺功能,值得推广.
Abstract
Objective:To compare thulium laser enucleation of the prostate(ThuLEP)with plasma kinetic resection of the prostate(PKRP)in the treatment of BPH.Methods:We retrospectively analyzed the medical records of 160 cases of BPH treated by ThuLEP(the observation group,n=80)or PKRP(the control group,n=80)in our hospital from January 2021 to December 2023.We recorded the operation time,bladder irrigation time,catheter retention time,hospitalization time,postoperative complica-tions,and pre-and postoperative maximum urinary flow rate(Qmax),residual urine volume(PVR),prostate-specific antigen(PSA)and prostate volume,followed by comparison of the data obtained between the two groups of patients.Results:Compared with the controls,the patients of the observation group showed significantly shorter operation time([67.25±7.24]vs[60.10±5.15]min,P<0.05),bladder irrigation time([46.90±10.77]vs[43.24±6.65]h,P<0.05),catheterization time([5.60±1.31]vs[5.03±1.24]d,P<0.05)and hospitalization time([7.31±2.00]vs[6.55±1.67]d,P<0.05),higher Qmax([18.50±1.24]vs[20.68±1.45]ml/s,P<0.05),lower PVR([12.10±3.53]vs[10.82±3.10]ml,P<0.05),PSA([4.60±0.78]vs[3.38±0.40]μg/L,P<0.05)and prostate volume([25.35±6.46]vs[20.12±5.13]ml,P<0.05)at 3 months after surgery,but no statistically significant difference in the total incidence of postoperative complications(7.50%[6/80]vs 5.00%[4/80],P>0.05).Conclusion:ThuLEP,with its advantages of notable effect,short operation and hospitaliza-tion time,significant improvement of urinary flow dynamics and prostate function,deserves clinical promotion for the treatment of BPH.