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中华腔镜泌尿外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (03) : 252 -256. doi: 10.3877/cma.j.issn.1674-3253.2023.03.011

临床研究

1 470 nm激光"平均三分法"剜除术与等离子剜除术治疗前列腺增生的比较
赖良海1, 赵伟1, 肖云新1, 杨伟明1, 陈光耀2,()   
  1. 1. 524000 湛江,广东医科大学第一临床医学院
    2. 529500 广东,阳江市人民医院泌尿外一科
  • 收稿日期:2022-03-02 出版日期:2023-06-01
  • 通信作者: 陈光耀

A comparative study of 1 470 nm laser "mean trichotomy " enucleation of the prostate and transurethral plasmakinetic enucleation for benign prostatic hyperplasia

Lianghai Lai1, Wei Zhao1, Yunxin Xiao1, Weiming Yang1, Guangyao Chen2,()   

  1. 1. Guangdong Medical University, Zhanjiang 524000, China
    2. Department of Urology, Yangjiang People's Hospital, Guangdong 529500, China
  • Received:2022-03-02 Published:2023-06-01
  • Corresponding author: Guangyao Chen
引用本文:

赖良海, 赵伟, 肖云新, 杨伟明, 陈光耀. 1 470 nm激光"平均三分法"剜除术与等离子剜除术治疗前列腺增生的比较[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 252-256.

Lianghai Lai, Wei Zhao, Yunxin Xiao, Weiming Yang, Guangyao Chen. A comparative study of 1 470 nm laser "mean trichotomy " enucleation of the prostate and transurethral plasmakinetic enucleation for benign prostatic hyperplasia[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(03): 252-256.

目的

比较1 470 nm半导体激光"平均三分法"前列腺剜除术(Mt-DiLEP)与经尿道双极等离子前列腺剜除术(PKEP)治疗前列腺增生(BPH)的安全性及疗效。

方法

本研究采用回顾性病例对照研究,根据不同手术方式将195例BPH患者分为两组,其中109例采用Mt-DiLEP治疗者为Mt-DiLEP组,86例采用PKEP治疗者为PKEP组。记录两组患者的术前一般资料,围手术期指标,术中和术后并发症及疗效指标等。

结果

Mt-DiLEP组与PKEP组手术时间差异无统计学意义(P>0.05),在术后住院时间、血红白蛋下降值及术后留置尿管时间方面Mt-DiLEP组要优于PKEP组,两组差异有统计学意义(P均<0.05)。术后随访3个月,两组术后的最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)较术前均有明显好转,术后两组Qmax、IPSS、QOL的差异均无统计学意义(P>0.05)。Mt-DiLEP组术中出血、术后尿道狭窄及出血等并发症较PKEP组少,差异有统计学意义(P<0.05)。

结论

Mt-DiLEP和PKEP用于治疗BPH两者的手术时间相近,临床疗效相似,但前者具有手术安全性高,术后并发症少,平均住院时间短等优点,是一种安全有效,值得临床推广应用的治疗方式。

Objective

To compare the safety and efficacy of 1 470 nm diode laser "mean trichotomy " enucleation of the prostate (Mt-DiLEP) and transurethral plasmakinetic enucleation (PKEP) in the treatment of benign prostatic hyperplasia (BPH).

Methods

195 patients with BPH were divided into two groups according to different surgical methods. 109 patients treated with Mt-DiLEP were divided into Mt-DiLEP group and 86 patients treated with PKEP were divided into PKEP group. Preoperative general data, perioperative indexes, intraoperative and postoperative complications and efficacy indexes of 2 groups were recorded and analyzed retrospectively.

Results

The operation time of the Mt-DiLEP group was similar to that of the PKEP group, and the Mt-DiLEP group was superior to the PKEP group in terms of postoperative hospital stay, decreased value of hemoglobin and catheter indwelling time, with statistical differences between the two groups (all P<0.05). The postoperative Qmax, IPSS and QOL of the two groups 3 months after surgery were significantly improved than before, and there was no statistical significance in the postoperative Qmax, IPSS and QOL of the two groups (P>0.05). Complications such as intraoperative bleeding, postoperative urethral stricture and bleeding in the Mt-DiLEP group were less than those in the PKEP group (P<0.05).

Conclusions

Mt-DiLEP and PKEP have similar operation time and clinical efficacy in the treatment of BPH. However, Mt-DiLEP has the advantages of high surgical safety, less postoperative complications, shorter average hospital stay, which is a safe and effective surgical treatment of BPH, and it is worthy of clinical application.

表1 两组BPH患者术前一般资料比较
图1 1 470 nm半导体激光"平均三分法"前列腺剜除术注:图a为标记环整体观;图b示膀胱颈8点处至预切环约8点处切沟;图c为中间部分前列腺剜除后整体观;图d为前列腺完整剜除后整体观
表2 两组BPH患者围手术期指标、术后3月疗效指标及术后并发症比较
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