【摘要】 目的 采用经尿道钬激光前列腺剜除手术（HoLEP）与经尿道前列腺电切手术（TURP）治疗前列腺增生的临床效果观察。方法 回顾性分析2018年1月至2021年6月我院收治的前列腺增生患者77例为研究对象，随机将患者分为两组，观察组39例，采用经尿道钬激光前列腺剜除手术治疗；对照组38例，采用经尿道前列腺电切手术治疗。比较两组患者围术期总手术时间、术中出血量、血红蛋白下降值、血钠变化值、膀胱冲洗时间、导尿管留置时间及总住院时间等指标；随访半年，观察两组患者国际前列腺症状评分（IPSS）、国际勃起功能指数评分（IIEF-5）、生活质量评分表（QOL）、最大尿流率(Q_max)、膀胱残余尿量（RUV）、勃起功能障碍（ED）、逆行射精（RE）发生情况及术中术后并发症情况。结果 钬激光组总手术时间长于电切组（P<0.001）；钬激光组患者的术中出血量、血红蛋白下降值及血钠变化值较电切组患者小，患者术后膀胱冲洗时间、导尿管留置时间及总住院时间较电切组患者缩短，两组比较差异有统计学意义（P均<0.001）；术后半年连续随访，钬激光组IIEF-5高于电切组（P<0.001），两组的IPSS、QOL、Q_max及RUV比较差异均无统计学意义（P均>0.05）；两组患者术后半年的ED及逆行射精的发生，以及术后并发症差异均无统计学意义（P均>0.05）。结论 采用HoLEP技术治疗前列腺增生疗效确切，安全性高，但远期疗效需扩大样本量进一步验证。更多还原

【Abstract】 Objective To investigate the clinical effects of using transurethral holmium laser enucleation of the prostate（HoLEP）versus transurethral resection of the prostate（TURP）for the treatment of BPH.Methods This is a retrospective study,seventy seven patients with prostatic hyperplasia admitted to our hospital from January 2018 to June 2021 were selected for the study and randomly divided into two groups. In the observation group,39 cases were treated with Ho LEP;in the control group,38 cases were treated with TURP. Comparing the two groups perioperative related indicators: total operative time,intraoperative bleeding,hemoglobin drop value,blood sodium change value,bladder flushing time,catheter retention time and total hospital stay. The patients in both groups were followed up for six months to observe the international prostate symptom score（IPSS）,international index of erectile function score（IIEF-5）,quality of life scale（QOL）,maximum urinary flow rate(Q_max),residual bladder urine volume（RUV）and intraoperative and postoperative complications. Results Total operative time was higher in the Ho LEP group than in the TURP group（P<0.001）. Intraoperative bleeding,hemoglobin drop and sodium change values were smaller in the Ho LEP group than in the TURP group,and postoperative bladder flushing time,catheter retention time and hospital stay were shorter in the Ho LEP group than in the TURP group,with statistically were significant（P all<0.001）.At six-month postoperative follow-up,the holmium laser group had a higher IIEF-5 than the electrodesiccation group（P<0.001）,and there was no significant difference in IPSS,QOL,Q_maxand RUV between the two groups（P all>0.05）. The status of ED and retrograde ejaculation and postoperative complications in both groups six months after surgery were not statistically significant（P all>0.05）. Conclusion Ho LEP technology is used to treat prostate enlargement with precise efficacy and high safety,lower intraoperative bleeding,reduce the magnitude of blood sodium changes,and have little impact on patients’ sexual function. However,the near-term efficacy and long-term efficacy need to be further validated by expanding the study sample size.更多还原