摘要
目的:探讨在经尿道低功率绿激光前列腺剜除术(VREP)中不同剜除方法的临床疗效和安全性。方法:回顾性分析2020年8月—2021年8月在我院行VERP术的98例良性前列腺增生(BPH)患者的临床资料,随访1年。47例使用分叶法剜除,51例使用整块法剜除,将其分为分叶法组和整块法组,比较两组的剜除效率、粉碎效率、手术时间、术后血红蛋白(HGB)下降值、术后最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、术后尿道狭窄及尿失禁的发生率。结果:两组剜除效率[(1.25±0.7)g/min vs.(1.24±0.8)g/min]、粉碎效率[(4.37±2.9)g/min vs.(4.32±2.7)g/min]、术后HGB下降值[(8.5±4.3)g/L vs.(8.2±4.4)g/L]的差异无统计学意义(均P>0.05)。两组术后3个月随访的Qmax[(21.6±3.5)mL/s vs.(21.3±3.6)mL/s]、IPSS[(8.8±1.8)分vs.(8.5±1.9)分]和QOL[(1.7±0.4)分vs.(1.8±0.3)分]的差异也无统计学意义(均P>0.05)。两组术后尿道狭窄的发生率相当(P>0.05)。分叶法组与整块法组的手术时间[(68.8±24.8)min vs.(82.5±30.9)min]和术后短暂性尿失禁发生率(4.3%vs.11.8%)的差异均有统计学意义(均P<0.05)。结论:在VREP中,分叶法和整块法疗效相当,但分叶法有更短的手术时间和更低的短暂性尿失禁发生率。
Objective:To explore the clinical efficacy and safety of different enucleation methods in transurethral low power green laser vapor-resection-enucleation of the prostate(VREP).Methods:The clinical data of 98 patients with benign prostatic hyperplasia(BPH)who underwent VERP in our hospital from August 2020 to August 2021 were retrospectively analyzed,and followed up for 1 year.47 cases were enucleated by split leaves method and 51 cases were enucleated by whole block method,which were divided into split leaves method group and whole block method group.The enucleation efficiency,pulverization efficiency,operation time,postoperative hemoglobin(HGB)decline,postoperative maximum urinary flow rate(Qmax),international prostate symptom score(IPSS),quality of life score(QOL),and the incidence of postoperative urethral stricture and urinary incontinence were compared between the two groups.Results:There was no significant difference between the two groups in enucleation efficiency[(1.25±0.7)g/min vs.(1.24±0.8)g/min],comminution efficiency[(4.37±2.9)g/min vs.(4.32±2.7)g/min],and postoperative HGB decline[(8.5±4.3)g/L vs.(8.2±4.4)g/L](all P>0.05).There was also no significant difference between the two groups in Qmax[(21.6±3.5)mL/s vs.(21.3±3.6)mL/s],IPSS[(8.8±1.8)vs.(8.5±1.9)]and QOL[(1.7±0.4)vs.(1.8±0.3)]at 3 months follow-up(all P>0.05).The incidence of urethral stricture was similar in the two groups(P>0.05).The operation time[(68.8±24.8)min vs.(82.5±30.9)min]and the incidence of postoperative transienturinary incontinence(4.3%vs.11.8%)in the split leaves method group and the whole block method group were significantly different(all P<0.05).Conclusion:In the transurethral low power green laser vapor-resection-enucleation of the prostate,the effect of the split leaves method is similar to that of the whole block method,but the split leaves method has shorter operation time and lower incidence of transienturinary incontinence.
作者
李泽宇
宋伟航
何岩
张春锋
刘沛
吴春磊
LI Ze-yu;SONG Wei-hang;HE Yan;ZHANG Chun-feng;LIU Pei;WU Chun-lei(Department 2 of Urology,First Affiliated Hospital,Xinxiang Medical University,Weihui 453100,China)
出处
《天津医科大学学报》
2023年第3期314-316,321,共4页
Journal of Tianjin Medical University
基金
2021年度新乡市前列腺疾病精准诊疗重点实验室(新科【2022】6号)。
关键词
分叶法
整块法
低功率绿激光
前列腺剜除
split leaves method
whole block method
low power green laser
prostate enucleation
