新型超脉冲钕-钇铝石榴石激光前列腺剜除术与等离子双极前列腺剜除术治疗前列腺增生疗效比较

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目的:比较经尿道新型钕-钇铝石榴石(Nd:YAG)激光前列腺剜除术(SPLEP)与等离子双极前列腺剜除术(PKEP)治疗前列腺增生(BPH)的疗效及安全性。方法:简单随机将2019年6月到2020年6月在武汉大学人民医院泌尿外科住院治疗的82例BPH患者分为两组,分别行SPLEP(41例)和PKEP(41例),术后随访3个月,并记录围手术期手术时间、血红蛋白(Hb)下降、膀胱冲洗时间、留置导尿管时间、术后住院时间和术后1、3个月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿量(PVR)以及并发症情况。组间计量资料比较采用独立样本n t检验,计数资料用n χ2检验。n 结果:SPLEP和PKEP两组手术时间分别为(70.90±25.81) min和(60.41±20.44) min,Hb下降分别为(14.61±6.47) g/L和(19.10±6.18) g/L,膀胱冲洗时间分别为(1.88±0.68) d和(2.27±0.67) d,留置导尿管时间分别为(5.93±1.03) d和(6.44±1.00) d,术后住院时间分别为(6.93±1.03) d和(7.66±1.18) d,差异均有统计学意义(n t=-2.039、3.212、2.618、2.278、2.993,n P0.05),差异无统计学意义。SPLEP组总并发症5例低于PKEP组的7例,但差异无统计学意义(n χ2=0.390,n P>0.05)。n 结论:SPLEP与PKEP均是治疗BPH的安全、有效的手术方式,与PKEP组比较,SPLEP组虽然手术时间稍长,但止血效果更好,膀胱冲洗时间、留置尿管时间、术后住院时间更短。“,”Objective:To investigate the efficacy and safety of new super pulse yttrium aluminium garnet (Nd: YAG)laser enucleation of the prostate (SPLEP) and bipolar plasmakinetic enucleation of the prostate (PKEP) in the treatment of benign prostatic hyperplasia (BPH)Methods:A total of 82 patients with BPH admitted to our hospital from June 2019 to June 2020 were randomly divided into two groups (SPLEP: 41 cases vs. PKEP: 41 cases), and followed up for 3 months. The perioperative operative time, decreased hemoglobin, bladder irrigation time, indwelling catheterization time, postoperative hospitalization time and international prostate symptom score (IPSS), quality of life score (QOL), maximum urinary flow rate (Qmax), postvoid residual (PVR), and complications were also recorded during the 3 months of follow-up. The measurement data between groups were compared by independent sample t-test, and the count data were analyzed by chi square test.Results:The operation time of SPLEP and PKEP groups was (70.90±25.81) min and (60.41±20.44) min, decrease of hemoglobin was (14.61±6.47) g/L and (19.10±6.18) g/L, the time of bladder irrigation was (1.88±0.68) days and (2.27±0.67) days, the indwelling catheter time was (5.93±1.03) days and (6.44±1.00) days, and the postoperative hospital stay was (6.93±1.03) days and (7.66±1.18) days, with the differences being statistically significant (n t=-2.039, 3.212, 2.618, 2.278, 2.993, n P0.05). There were 3 cases of transient urinary incontinence in SPLEP group and 6 cases in PKEP group (n χ2=1.123, n P>0.05). complications occurred in 5 cases in SPLEP group, less than 7 cases in PKEP group (n χ2=0.390, n P>0.05).n Conclusion:Both SPLEP and PKEP are safe and effective surgical methods in the treatment of BPH.compared with PKEP group, although the operation time in SPLEP group is slightly longer, the hemostatic effect is better, the bladder irrigation time, indwelling catheter time and postoperative hospitalization time are shorter in SPLEP group.
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