摘要
目的探讨经尿道前列腺等离子切除术(PKRP)与经尿道铥激光前列腺剜除术(ThuLEP)治疗良性前列腺增生(BPH)的临床疗效。方法选取2023年10月至2025年4月苏州大学附属第四医院收治的160例BPH患者,根据手术方式不同分为PKRP组(80例)和ThuLEP组(80例),比较两组围手术期指标、症状严重程度[国际前列腺症状评分(IPSS)]、尿动力学指标[最大尿流率(Qmax)、排尿时间]以及并发症发生率。结果与PKRP组比较,ThuLEP组手术时间、膀胱冲洗时间、导尿管留置时间更短,出血量更少,前列腺切除体积更大[(58±12)min比(65±14)min(15±3)h比(24±4)h、(3.2±0.6)d比(4.5±0.8)d、(59±14)ml比(74±21)ml、(47±12)ml比(38±12)ml](均P<0.01)。治疗前后IPSS的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间IPSS的主效应差异有统计学意义(P<0.01);IPSS的时点间与组间存在交互作用(P<0.01),两组术后IPSS均呈下降趋势,但变化幅度不同,ThuLEP组术后1个月、3个月的IPSS均低于PKRP组(P<0.01)。术后3个月,两组Qmax均升高、排尿时间均缩短,ThuLEP组Qmax高于PKRP组,排尿时间短于PKRP组[(21.7±4.2)ml/s比(19.2±3.6)ml/s、(18.3±3.3)s比(21.3±4.1)s](P<0.01)。ThuLEP组术后并发症发生率低于PKRP组[11.25%(9/80)比25.00%(20/80)](P<0.05)。结论与PKRP相比,ThuLEP治疗BPH患者的腺体切除更彻底、术后康复更快、中短期症状与功能改善更佳,且总体并发症发生率更低。
Objective To explore the clinical efficacy of transurethral plasmakinetic resection of the prostate(PKRP)and transurethral thulium laser enucleation of the prostate(ThuLEP)in the treatment of benign prostatic hyperplasia(BPH).MethodsA total of 160 patients with BPH admitted to the Fourth Affiliated Hospital of Soochow University from Oct.2023 to Apr.2025 were included and divided into a PKRPgroup(80cases)and a ThuLEPgroup(80 cases)according to different surgical methods.The perioperative indicators,symptom severity[international prostate symptom score(IPSS)],urodynamic indicators[maximum urine flow rate(Qmax),urination time]and the incidence of complications were compared between the two groups.Results Compared with the PKRP group,the ThuLEP group had shorter operation time,bladder irrigation time,indwelling catheter time,and less bleeding,while the volume of prostatectomy was larger[(58±12)min vs(65±14)min,(15±3)h vs(24±4)h,(3.2±0.6)d vs(4.5±0.8)d,(59±14)ml vs(74±21)ml,(47±12)ml vs(38±12)ml](all P<0.01).The main effect difference of IPSS before and after treatment was statistically significant(P<0.01).Regardless of the measurement time,there was a statistically significant difference in the main effect of IPSS between the two groups(P<0.01).There was an interaction between the time points and groups of IPSS(P<0.01).The IPSS of both groups showed a downward trend after the operation,but the amplitude of change was different.The IPSS of the ThuLEP group at 1 month and 3 months after the operation was lower than that of the PKRPgroup(P<0.01).Three months after the operation,the Qmax in both groups increased and the urination time was shortened.The Qmax in the ThuLEPgroup was higher than that in the PKRP group,and the urination time wasshorter than that in the PKRP group[(21.7±4.2)ml/s vs(19.2±3.6)ml/s,(18.3±3.3)s vs(21.3±4.1)s](P<0.01).The incidence of postoperative complications in the ThuLEP group was lower than that in the PKRPgroup[11.25%(9/80)vs 25.00%(20/80)](P<0.05).Conclusion Compared with PKRP,ThuLEP in the treatment of BPH patients sees more thorough glandular resection,faster postoperative recovery,better improvement in medium and short-term symptoms and functions,and a lower overall complication rate.
作者
丁猛
陆兵
DING Meng;LU Bing(Department of Urology,the Fourth Affiliated Hospital of Soochow University,Suzhou 215021,China)
出处
《医学综述》
2025年第21期2760-2764,共5页
Medical Recapitulate
关键词
良性前列腺增生
最大尿流率
尿道前列腺等离子切除术
尿道铥激光前列腺剜除术
Benign prostatic hyperplasia
Maximum urine flow rate
Transurethral plasmakinetic resection of the prostate
Transurethral thulium laser enucleation of prostate
