摘要
目的探讨低功率60 W(1.5 J×40 Hz)经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效及安全性。方法回顾分析我院2018年6月~2020年6月120例需要手术治疗的BPH患者的临床资料,依据钬激光参数不同分为2组:60 W组(1.5 J×40 Hz低功率HoLEP)和100 W组(2.5 J×40 Hz高功率HoLEP),各60例,比较2组手术时间、术后并发症、膀胱冲洗时间、留置导尿管时间及住院时间等,手术前后国际前列腺症状评分(International Prostate Symptom Score,IPSS)、生活质量(quality of life,QOL)评分、最大尿流率(Qmax)、残余尿量(residual urine,RU)改善情况。结果60 W组与100 W组手术时间[(56.6±7.3)min vs.(55.1±6.3)min,t=1.207,P=0.230],术后并发症发生率[3.3%(2/60)vs.8.3%(5/60),χ^(2)=0.607,P=0.436]、膀胱冲洗时间[(1.6±0.3)d vs.(1.7±0.2)d,t=-0.571,P=0.569]、留置导尿管时间[(1.9±0.4)d vs.(2.0±0.5)d,t=-1.379,P=0.170]和术后住院时间[(3.6±0.6)d vs.(3.7±0.5)d,t=-0.866,P=0.388]差异无显著性。术后2个月随访,2组术后IPSS、QOL、Qmax、RU与术前比较均有明显改善(P<0.05)。暂时性尿失禁60 W组1例,100 W组3例,2组比较差异无显著性(P=0.611)。结论低功率60 W(1.5 J×40 Hz)HoLEP治疗BPH安全可靠,与高功率的疗效相当。
Objective To evaluate the safety and efficacy of holmium laser enucleation of the prostate(HoLEP)with low power 60 W(1.5 J×40 Hz)laser device.Methods From June 2018 to June 2020,120 patients with benign prostatic hyperplasia(BPH)underwent HoLEP in our hospital.The patients were divided into two groups.In the low-power group(60 patients),the HoLEP were performed with 60 W setting(1.5 J×40 Hz);while in the high-power group(60 patients),the HoLEP were performed with 100 W setting(2.5 J×40 Hz).The operative time,postoperative complications,bladder flushing time,catheter retention time and hospitalization time were compared between the two groups.The preoperative and postoperative international prostate symptom score(IPSS),quality of life(QOL),Qmax and residual urine(RU)were compared between the two groups.Results There were no significant differences between the two groups regarding operative time[(56.6±7.3)min vs.(55.1±6.3)min,t=1.207,P=0.230],postoperative complications[3.3%(2/60)vs.8.3%(5/60),χ^(2)=0.607,P=0.436],bladder flushing time[(1.6±0.3)d vs.(1.7±0.2)d,t=-0.571,P=0.569],catheter retention time[(1.9±0.4)d vs.(2.0±0.5)d,t=-1.379,P=0.170]and hospitalization time[(3.6±0.6)d vs.(3.7±0.5)d,t=-0.866,P=0.388].Postoperative follow-ups for 2 months showed significant improvement in IPSS,QOL,Qmax,and RU(P<0.05)in both groups as compared with the baseline data.Temporary urinary incontinence was found in 1 case in the low-power group and 3 cases in the high-power group,without significant difference between the two groups(P=0.611).Conclusion HoLEP at 60 W(1.5 J×40 Hz)is safe and reliable for BPH,being as efficient as the high-power enucleation.
作者
范帅
常保东
王雷阳
张力
葛永超
冯金顺
张明伟
任行飞
费兴业
周诣桐
Fan Shuai;Chang Baodong;Wang Leiyang(Department of Urology, Zhengzhou Third People’s Hospital, Zhengzhou 450000, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2022年第4期318-322,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
低功率
高功率
前列腺钬激光剜除术
良性前列腺增生
Low power
High power
Holmium laser enucleation of the prostate
Benign prostatic hyperplasia
