HoLEP对良性前列腺增生的疗效及安全性观察

目的:探讨以尿道钬激光前列腺剜除术(HoLEP)治疗良性前列腺增生(BPH)的临床疗效和安全性。方法:选取我院102例以HoLEP术治疗的BPH患者的临床资料,分析BPH患者的年龄、切除腺体的大小、手术出血量、手术前后的最大尿流率(Qmax)、最大尿流率时逼尿肌压(Pdet/Qmax)、国际前列腺症状评分表(IPSS)评分和生活质量评分(QOLS)等。再选取我院100例以尿道前列腺电切术(TURP)治疗的BPH患者的临床资料,对比两组患者并发症的发生情况。结果:102例BPH患者的年龄为(71.58±9.74)岁,切除腺体为(84.32±36.39)g,手术出血量为(146±24.68)mL,手术前的最大尿流率(8.37±5.28)mL/s,最大尿流率时逼尿肌压为(72.93±26.49)cm H_2O,IPSS评分为(28.8±5.98)分,QOLS评分为(5.8±0.46)分;手术后的最大尿流率(24.77±5.89)mL/s,最大尿流率时逼尿肌压为(42.35±10.37)cm H_2O,IPSS评分为(9.4±1.28)分,QOLS评分为(2.8±0.28)分。手术后的Qmax明显升高(P0.05),而Pdet/Qmax、IPSS评分和QOLS均显著降低(P0.05)。HoLEP术治疗的BPH患者并发症发生明显低于尿道前列腺电切术(TURP)治疗的患者(P0.05)。结论:HoLEP是一种安全有效的治疗BPH的微创手术。

The Curative Effect and Safety of the HoLEP in Treatment of BPH

ABSTRACT Objective: To observe the clinical efficacy and safety of the HoLEP treatment of BPH. Methods: 102 BPH patients with HoLEP clinical data were collected in our hospital. Age of the BPH patients, size of their removal gland, surgical blood loss, as well as the Qmax, the Pdet/ Qmax, IPSS and QOLS before and after operation were analyzed. Then another 100 BPH patients treated with TURP clinical data in our hospital were selected and complications of the patients were compared between the two groups. Results: The age of 102 BPH patients was (71.58±9.74) years. The removal glands of patients was (84.32±36.39)g. The loss of surgical blood was (146±24.68) mL. Before the operation, the Qmax was(8.37±5.28) mL/s, Pdet/ Qmax (72.93±26.49) cm H₂O, IPSS (28.8±5.98), and QOLS (5.8±0.46). After the operation, the Qmax of patients was (24.77±5.89) mL/s, Pdet/ Qmax of patients (42.35±10.37) cm H₂O, IPSS (9.4±1.28), and QOLS (2.8±0.28), which means that Qmax increased significantly (P<0.05), while Pdet/ Qmax, IPSS score and QOLS were significantly lower (P<0.05). Complications occurred significantly less with BPH patients of HoLEP treatment than that with TURP (P<0.05). Conclusion: HoLEP is a safe and effective minimally invasive surgery in the treatment of BPH.