摘要
目的比较高、低功率经尿道前列腺钬激光刻除术(HoLEP)对不同体积良性前列腺增生(BPH)的治疗效果。方法收集2018年1月至2020年1月在本院治疗的163例前列腺增生患者的临床资料。根据前列腺体积大小分为中体积(MVG组)[30mL<前列腺体积<80mL,试验A1组(43例)、对照B1组(37例)]和大体积(LVG组)【前列腺体积>80mL,试验A2组(41例)、对照B2组(42例)】。试验A1、A2组行低功率(50W)铁激光刻除术(LP-Ho-LEP);对照B1、B2组行高功率(80W)钬激光刻除术(HP-HoLEP)。比较各组年龄、国际前列腺症状评分(IPSS)、最大尿流率(Q_(max))、残余尿(PVR)、前列腺体积、刻除时间、粉碎时间、腺体刻除质量、术后住院时间、术后尿管留置时间、血红蛋白(Hb)下降值、刻除效率等。采用多重线性回归分析影响术中出血因素以及logistic回归分析引起术后尿失禁的风险因素。结果试验A1组与对照B1组的刻除时间、粉碎时间、腺体刻除质量和除效率比较,差异均无统计学意义(均P>0.05);试验A1组的术后住院时间、术后尿管留置时间和Hb下降值少于对照B1组(均P<0.05)。试验B2组的刻除时间、术后住院时间、术后尿管留置时间多余对照B2组,刻除效率低于对照B2组(均P<0.05)。试验B2组与对照B2组的腺体刻除质量和Hb下降值比较,差异均无统计学意义(均P>0.05)。采用多重线性分析术中出血量,结果显示,钬激光功率和前列腺体积是影响术中出血量的主要因素,且钬激光功率影响较大(均P<0.05)。采用logistic单因素和多因素回归分析引起压力性尿失禁的风险因素,结果显示,腺体劑除质量和刻除时间是术后尿失禁的独立危险因素(均P<0.05)。术后1、6、12个月各组IPSS评分、PVR均低于术前,Q_(max)高于术前,差异均有统计学意义(均P<0.05)。结论LP-HoLEP的刻除时间、粉碎时间、腺体刻除质量和刻除效率与HP-HoLEP比较无明显差异,而且止血效果较好,�
Objective To compare the effect of high and low transurethral holmium laser enucleation of the prostate(HoLEP)on different volume benign prostate hyperplasia(BPH).Methods The clinical data of 163 patients with prostatic hyperplasia from January 2018 to January 2020 were collected.According to the prostate volume size,the prostate was divided into medium volume(MVG group)[30 mL<prostate volume<80 mL,test group A1(43 cases),control group B1(37 cases)]and large volume(LVG group)[prostate volume>80 mL,test group A2(41 cases),control group B2(42 cases)].Low power holmium laser ensnare(LP-HoLEP)was performed in the experimental group,the power was 50 W.The control group received high power holmium laser entrainment(HPHoLEP)with the power of 80 W.Age,international prostate symptom score(IPSS),maximum urinary flow rate(Q_(max)),residual urine(PVR),prostate volume,enucleation time,crushing time,glandular enucleation quality,postoperative hospital stay,postoperative indenture time,hemoglobin(Hb)decline value,enucleation efficiency,etc.,were compared among all groups.Multiple linear regression analysis was used to analyze the factors affecting intraoperative bleeding and logistic regression analysis of the risk factors causing postoperative urinary incontinence.Results There were no significant differences in enucleation time,crushing time,gland quality and efficiency between test group Al and control group B1(all P>0.05).There were statistically significant differences in postoperative hospital stay,postoperative catheter indent time and Hb decline value between test group Al and control group B1(all P<0.05).The postoperative hospital stay,urinary catheter retention time and Hb decline value of test group Al were lower than those of control group Bl,and the differences were statistically significant(all P<0.05).The enucleation time,postoperative hospital stay and urinary catheter retention time in experimental group B2 were higher than those in control group B2,and the enucleation efficiency was lower than that in control
作者
顾志波
苏倩
陈建刚
陆明
Gu Zhibo;Su Qian;Chen Jiangang;Lu Ming(Department of Urology,Nantong No.1 People's Hospital,Nantong 226200,China)
出处
《国际泌尿系统杂志》
2023年第5期845-849,共5页
International Journal of Urology and Nephrology
基金
南通市科技局指导性课题(MSZ19135)。
