论文部分内容阅读
目的:比较钬激光前列腺剜除术(Ho LEP)和120W铥激光前列腺汽化剜除术(Thu VEP)在治疗良性前列腺增生引起的下尿路症状中的临床效果,以及对术后勃起功能的影响。方法:回顾性研究93例分别采用Ho LEP和Thu VEP治疗的良性前列腺增生患者,比较两组患者手术前后临床及手术参数,比较术前及术后12个月随访期间,患者国际前列腺症状评分(IPSS)、生活质量(Qo L)指数、最大尿流率(Qmax)及残余尿量(PVR),并比较国际勃起功能问卷(IIEF)的勃起功能专项评分(IIEF-EF)。结果:Thu VEP组激光平均剜除时间为(57.6±12.8)min,Ho LEP组为(70.4±21.8)min,差异有统计学意义(P=0.001),120 W铥激光组的前列腺剜除效率为(0.71±0.18)g/min,钬激光组为(0.62±0.19)g/min,差异有统计学意义(P=0.021)。在术后1个月、6个月、12个月随访期间,两组间IPSS、Qo L指数、Qmax及PVR的差异均无统计学意义(P>0.05)。两组围手术期及术后晚期并发症发生率均较低,差异均无统计学意义(P>0.05)。Ho LEP和Thu VEP术后平均IIEF-EF较术前略有改善,差异均无统计学意义(P>0.05)。但对术前勃起功能相对正常的患者,Ho LEP术后平均IIEF-EF评分为(21.0±2.7)分,术前为(22.8±2.2)分,差异有统计学意义(P=0.036)。结论:Ho LEP和Thu VEP均可有效缓解BPH引起的下尿路症状,其短期效果相当,均具有良好的安全性。与钬激光相比,120 W铥激光前列腺剜除效率较高。Ho LEP和Thu VEP术后勃起功能改善不显著,但对术前勃起功能相对正常的患者,Ho LEP术后短期内勃起功能可能有轻度下降。
OBJECTIVE: To compare the clinical effects of holmium laser (Ho LEP) and 120 W Th laser prostatectomy (Thu VEP) in treating lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) and its effect on postoperative erectile function . Methods: A retrospective study of 93 patients with benign prostatic hyperplasia treated with Ho LEP and Thu VEP was performed. The clinical and surgical parameters of the two groups were compared before and after surgery. The scores of International Prostate Symptom Score IPSS, QoL, Qmax, and residual urine volume (PVR). The IIEF-EF was compared with the IIEF. Results: The average laparotomy time was (57.6 ± 12.8) min in Thu VEP group and (70.4 ± 21.8) min in Ho LEP group, the difference was statistically significant (P = 0.001) (0.71 ± 0.18) g / min for the holmium laser group (0.62 ± 0.19) g / min, the difference was statistically significant (P = 0.021). There was no significant difference in IPSS, QoL index, Qmax and PVR between the two groups at 1 month, 6 months and 12 months after operation (P> 0.05). The incidence of complications in both the perioperative period and the late postoperative period was lower in both groups, with no significant difference (P> 0.05). The average IIEF-EF after operation of Ho LEP and Thu VEP was slightly improved compared with that before operation, and the difference was not statistically significant (P> 0.05). However, for patients with relatively normal preoperative erectile function, the average IIEF-EF score after Ho LEP surgery was (21.0 ± 2.7) minutes and (22.8 ± 2.2) minutes before surgery, respectively. The difference was statistically significant (P = 0.036). CONCLUSION: Both Ho LEP and Thu VEP can effectively relieve the lower urinary tract symptoms caused by BPH, and have short-term effect and good safety. Compared with holmium laser, 120 W 铥 laser prostate gland removal efficiency is higher. There was no significant improvement in erectile function after Ho LEP and Thu VEP, but there was a slight decrease in erectile function after Ho LEP in patients with relatively normal preoperative erectile function.