摘要
目的:探讨不同手术方式治疗良性前列腺增生的疗效及对尿动力学和勃起功能的影响。方法:选取121例行手术治疗的BPH患者为研究对象,按手术方式不同分为钕钇铝石榴石激光组(Nd∶YAG激光组,n=45)与等离子双极前列腺切除术组(PPKE组,n=76)。Nd∶YAG激光组患者行Nd∶YAG激光前列腺剜除术治疗;PPKE组患者行PPKE治疗。比较两组患者围术期一般指标[手术时间、术中出血量、术后血红蛋白(Hb)下降值、留置导尿管时间和术后住院时间];术前及术后6个月前列腺症状[国际前列腺症状(IPSS评分)]、生活质量评分[生活质量评定量表(QOL)评分]、尿动力学[残余尿量(PVR)、最大尿流率(Qmax)]、勃起功能[国际勃起功能指数(IIEF-5)];并发症发生情况。结果:与PKEP组相比,Nd∶YAG激光组术后出血量较少,Hb下降值较低,留置导尿管时间和术后住院时间较短,差异均有统计学意义(P<0.05);两组患者手术时间差异无统计学意义(P>0.05)。术后6个月,两组患者IPSS评分、QOL评分和PVR均下降(P<0.05),Qmax均增高(P<0.05),但组间差异无统计学意义(P>0.05);IIEF-5评分均下降(P<0.05),且Nd:YAG激光组高于PKEP组(P<0.05)。两组患者术后并发症比较,差异无统计学意义(P>0.05)。结论:Nd∶YAG激光前列腺剜除术是治疗BPH的安全有效术式,相比于PKEP,出血少,术后恢复快,对勃起功能影响小。
Objective:To investigate the efficacy of different surgical methods in the treatment of benign prostatic hyperplasia(BPH)and their effects on urodynamics and erectile function.Methods:A total of 121 patients with BPH who underwent surgical treatment were enrolled in the study.They were divided into neodymium yttrium aluminum garnet laser group(Nd:YAG laser group,n=45)and and plasma bipolar prostatectomy group(PKEP group,n=76)according to different surgical methods.The perioperative general data[surgical time,intraoperative blood loss,postoperative hemoglobin(Hb)decrease,indwelling catheter time,and postoperative hospital stay],international prostate symptom score(IPSS),quality of life score(QOL),urodynamics[residual urine volume(PVR),maximum urinary flow rate(Qmax)],erectile function[international index of erectile function(IIEF-5)]before and 6 months after operation,and complications were compared between the two groups.Results:Compared with the PKEP group,the Nd:YAG laser group had less postoperative bleeding,lower Hb decline,shorter indwelling catheter time and postoperative hospital stay,and the differences were significant(P<0.05).There was no statistically significant difference in surgical time between the two group(P>0.05).At 6 months after operation,IPSS score,QOL score and PVR of the two groups decreased(P<0.05),and Qmax increased(P<0.05),there was no significant difference between the two groups(P>0.05).At 6 months after operation,the IIEF-5 score of pelvic floor muscles in both groups decreased(P<0.05),and the IIEF-5 score of pelvic floor muscles in the Nd:YAG laser group was higher than that in the PKEP group(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion:Nd∶YAG laser enucleation of the prostate is a safe and effective procedure for the treatment of BPH.Compared with PKEP,it not only has less bleeding and faster postoperative recovery,but also has little effect on erectile function.
作者
刘兆月
严慧芳
靳珊珊
LIU Zhao-yue;YAN Hui-fang;JIN Shan-shan(Department of Urology,Hengshui People s Hospital,Hengshui 053000,Hebei,China;Department of Pediatric Internal Medicine,Hengshui People s Hospital,Hengshui 053000,Hebei,China)
出处
《川北医学院学报》
CAS
2023年第11期1500-1503,共4页
Journal of North Sichuan Medical College
基金
哈励逊国际和平医院科研项目(20181570)。
