【摘要】 目的比较经尿道钬激光前列腺剜除术(HOLEP)和经尿道前列腺汽化电切术(TUEVP)治疗良性前列腺增生症(BPH)的效果。方法前列腺增生症(BPH)患者106例随机分为两组,分别行HOLEP和TUEVP,监测、记录两组患者术前、术中及术后的相关临床指标,进行分析、对比。结果术前两组一般情况比较差异无统计学意义(P>0.05)。HOLEP组手术时间(78.5±27.3)min,术中冲洗液量(28.3±7.9)L;TUEVP组手术时间(56.2±21.9)min,术中冲洗液量(18.6±6.8)L,两组间比较差异有显著性(P<0.01)。HOLEP组术中出血量(129.9±46.9)mL、术后出血量(31.8±15.7)mL、膀胱冲洗时间(2.8±0.9)d、留置导尿管时间(5.1±0.6)d均小于TUEVP组[术中出血量(169.9±86.9)mL,术后出血量(44.4±24.5)mL,膀胱冲洗时间(3.3±0.6)d,留置导尿管时间(5.5±0.7)d],P<0.05。术后随访1～6个月,两组IPSS、QOL、Qmax较术前均明显改善(P<0.01);HOLEP组发生尿道狭窄2例,尿失禁1例,无阳痿发生;TUEVP组发生尿道狭窄5例、尿失禁3例、阳痿2例,两组间比较差异无统计学意义(P>0.05)。结论HOLEP治疗前列腺增生症,效果可靠,与TUEVP相比,并发症少,适应证广,值得进一步推广应用。更多还原

【Abstract】 Objective To compare the efficacy of holmium laser enucleation of the prostate (HOLEP) with transurethral electrovaporization resection of the prostate (TUEVP) for the treatment of benign prostatic hyperplasia (BPH). Method 106 cases of BPH were divided into two groups randomly, of them 52 cases underwent HOLEP and 54 cases, TUEVP. The significant markers and therapeutic results were recorded and analyzed. Result There was no significant difference between the two groups in some preoperative factors (P >0.05). The time of operation for TUEVP was (56.2±21.9) min, shorter than that for HOLEP, (78.5±27.3) min. The volume of irrigating fluid during operation for TUEVP was(18.6±6.8) L, less than that for HOLEP,(28.3±7.9) L. Significant difference was found between the two groups(P <0.01). However, the blood loss in operation for HOLEP was (129.9±46.9) mL, less than that for TUEVP, (169.9±86.9) mL. The blood loss after operation was (31.8±15.7)mL in HOLEP group, and (44.4±24.5)mL in TUEVP group. The time of bladder irrigating after operation was (2.8±0.9) d in HOLEP group, (3.3±0.6)d in TUEVP group. The time of catheterization was (5.1±0.6) d in HOLEP group, shorter than the(5.5±0.7)d in TUEVP group. Significant difference was found between the two groups in the above four markers(P <0.05). All the cases were followed up for 1 to 6 months. IPSS, QOL and Qmax were improved significantly compared with that of preoperative (P <0.01). There were 5 cases of urethral stricture and 3 cases of Incontinence of urine and 2 cases of impotence in the TUEVP group. While 2 cases of urethral stricture and 1 cases of Incontinence of urine and 0 cases of impotence were found in the HOLEP group. No significant difference was found between the two groups (P >0.05). Conclusion HOLEP is effective as TUEVP, however, with less obtainment of adverse side effect and wider adaptation. It should be performed extensively.更多还原