经尿道前列腺红激光剜除术与电切术治疗大体积良性前列腺增生的疗效及安全性比较

张益萍; 胡锦新; 朱军; 曹廷虎

doi:10.19428/j.cnki.sjpm.2017.04.014

经尿道前列腺红激光剜除术与电切术治疗大体积良性前列腺增生的疗效及安全性比较

Comparative study on the efficacy and safety of diode laser enucleation and transurethral resection of prostate in the treatment of large-volume benign prostatic hyperplasia

摘要

摘要:
目的比较经尿道前列腺红激光剜除术和电切术治疗大体积良性前列腺增生的疗效及安全性。
方法通过回顾性分析上海市宝山区中西医结合医院2014年1月至2016年12月收治的80例大体积良性前列腺增生患者，分别采用经尿道前列腺红激光剜除术及经尿道前列腺电切术，比较两组手术时间、术后血红蛋白下降值、切除前列腺质量、术后血清钠离子变化率、术后并发症、手术前后国际前列腺症状评分、残尿量、最大尿流率等。
结果经过术后随访6个月，两组国际前列腺症状评分、最大尿流率、生活质量评分无明显差异。经尿道红激光前列腺剜除组术后血红蛋白下降值、术后血清钠下降值、膀胱冲洗时间、留置尿管时间及住院时间均明显低于前列腺电切组。经尿道红激光前列腺剜除术及电切术两组手术时间(120.5±25.2)min vs(95±21.2)min、切除组织质量(68.5±16.2)g vs(65.2±18.5)g、术后血红蛋白下降值(0.89±0.42)g/dL vs(1.24±0.56)g/dL、血清钠离子下降值(5.2±1.5)mmol/L vs(14.5±2.8)mmol/L、膀胱灌注时间(28.5±5.9)h vs(48.5±6.7)h、导尿管留置时间(2.6±1.8)d vs(4.8±2.2)d和住院时间(6.2±1.8)d vs(9.2±2.3)d比较，差异均有统计学意义(P均 < 0.05)；两组术后并发症如术后出血、术后输血、重置导尿、刺激症状、逆行射精、尿失禁、尿道狭窄、电切综合征等差异均有统计学意义(P均 < 0.05)。
结论与经尿道前列腺电切术相比，经尿道前列腺红激光剜除术治疗大体积良性前列腺增生出血风险更小，膀胱冲洗、留置尿管及住院时间更短，术后并发症少，具有良好的疗效及安全性。

Abstract:
ObjectiveTo compare the efficacy and safety of diode laser enucleation of prostate(DiLEP) and transurethral resection of prostate(TURP) in the treatment of large-volume benign prostatic hyperplasia(BPH).
MethodsA total of 80 cases of large-volume BPH patients who were treated in Shanghai Baoshan Traditional Chinese Medcine-integrated Hospital from January, 2014 to December, 2016 were selected. These patients were divided into two groups who were treated by DiLEP and TURP, respectively. The operation time, postoperative hemoglobin slippage, removed tissue weight, postoperative serum sodium slippage, postoperative complications, International Prostate Symptom Score (IPSS) before and after surgery, residual urine volume (PVR) and the maximum urinary flow-rate (Q_max), etc. of the two groups were compared.
ResultsIn the postoperative follow-up during 6 months after surgery, the IPSS before and after surgery, Q_max and Quality of Life (QOL) scores of the two groups showed no significant difference. The postoperative hemoglobin slippage, postoperative serum sodium slippage, vesical infusion time, urinary canal indwelling time and length of stay of the DiLEP group were all below those of the TURP group. The operation time: (120.5±25.2)min vs(95±21.2)min; the quality of exercised tissues: (68.5±16.2)g vs (65.2±18.5)g; the postoperative hemoglobin slippage: (0.89±0.42)g/dL vs (1.24±0.56)g/dL; the postoperative serum sodium slippage: (5.2±1.5)mmol/L vs (14.5±2.8)mmol/L; the vesical infusion time: (28.5±5.9)h vs (48.5±6.7)h; the urinary canal indwelling time: (2.6±1.8)d vs (4.8±2.2)d; the length of stay: (6.2±1.8)d vs (9.2±2.3)d of both the DiLEP group and the TURP group all showed significant differences(all P < 0.05). The postoperative complications, such as postoperative hemorrhage, postoperative blood transfusion, reset urethral catheterization, irritation symptoms, retrograde ejaculation, urinary incontinence, urethral stricture, electroresection syndrome, etc. of the two groups had significant differences(P < 0.05).
ConclusionFor the treatment of large-volume BPH, DiLEP as compared with TURP, has less hemorrhage risks, requires less time in terms of vesical infusion time, urinary canal indwelling time and length of stay, has less postoperative complications, thus having good therapeutic effect and safety.

HTML全文

参考文献(15)

施引文献

资源附件(0)