經(jīng)尿道前列腺鈥激光剜除術(shù)與經(jīng)尿道前列腺電切術(shù)治療老年良性前列腺增生癥療效比較分析

　　[摘要] 目的 探討經(jīng)尿道前列腺鈥激光剜除術(shù)與經(jīng)尿道前列腺電切術(shù)治療老年良性前列腺增生癥療效。方法 方便選取2015年5月—2016年5月76例老年良性前列腺增生癥患者作為研究對(duì)象，根據(jù)方法分組，各有38例。電切組采用經(jīng)尿道前列腺電切術(shù)治療，鈥激光剜除組采用經(jīng)尿道前列腺鈥激光剜除術(shù)治療。比較兩組老年良性前列腺增生癥治療總有效率；術(shù)中出血量、沖洗膀胱時(shí)間、尿管置管時(shí)間；患者殘留尿量、IPSS評(píng)分、最大尿流率；尿道狹窄、排尿困難等并發(fā)癥發(fā)生率。結(jié)果 鈥激光剜除組老年良性前列腺增生癥治療總有效率94.74%和電切組92.11%之間差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）；兩組殘留尿量、IPSS評(píng)分、最大尿流率相近，其中，鈥激光剜除組（17.24±3.20）mL、（1.24±0.74）分和（21.14±5.41）mL/s，電切組（16.41±3.24）mL、（1.25±0.47）分、（21.24±5.89）mL/s（P>0.05）；鈥激光剜除組尿道狹窄、排尿困難等并發(fā)癥發(fā)生率低于電切組（P<0.05）。其中，電切組有3例出現(xiàn)尿道狹窄，3例出現(xiàn)排尿困難，2例出血，發(fā)生率21.05%；鈥激光剜除組有1例出現(xiàn)尿道狹窄，發(fā)生率2.63%。鈥激光剜除組術(shù)中出血量、沖洗膀胱時(shí)間、尿管置管時(shí)間（97.10±20.34）mL、（24.16±18.25）h、（1.62±0.38）d優(yōu)于對(duì)照組（130.55±24.52）mL、（48.86±20.46）h、（2.45±1.34）d（P<0.05）。結(jié)論 經(jīng)尿道前列腺鈥激光剜除術(shù)治療老年良性前列腺增生癥療效和經(jīng)尿道前列腺電切術(shù)相當(dāng)，均可有效改善患者臨床癥狀，改善排尿情況，但其中以經(jīng)尿道前列腺鈥激光剜除術(shù)安全性更高，可減輕手術(shù)創(chuàng)傷，減少出血量，減少并發(fā)癥，加速術(shù)后康復(fù)。
　　[關(guān)鍵詞] 經(jīng)尿道前列腺鈥激光剜除術(shù)；經(jīng)尿道前列腺電切術(shù)；老年良性前列腺增生癥；療效
　　[中圖分類(lèi)號(hào)] R4 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2018）01（c）-0076-03
　　[Abstract] Objective This paper tries to investigate the efficacy of transurethral resection of transhepatic holmium laser and transurethral resection of prostate for the treatment of benign prostatic hyperplasia in the elderly. Methods From May 2015 to May 2016， 76 patients with benign prostatic hyperplasia （BPH） were convenient divided into groups according to different methods， each with 38 cases. Transurethral resection of the prostate was treated with transurethral resection of the holmium laser group with transurethral holmium laser excision. The total effective rate of the patients with benign prostatic hyperplasia （BPH） was compared between the two groups. The intraoperative blood loss， bladder irrigation time， catheterization time， patient residual urine volume， IPSS score， maximal uroflow rate， urethral stricture and dysuria rate were compared. Results There was no significant difference in the total effective rate of 94.74% and 92.11% between the group of holmium laser and the group of benign prostatic hyperplasia （P>0.05）. The residual urine volume， the IPSS score and the maximum uroflow rate were similar in both groups， laser ablation group（17.24±3.20）mL， （1.24±0.74）points and （21.14±5.41）mL/s， the cut-off group（16.41±3.24）mL，（1.25±0.47）points，（21.24±5.89）mL/s（P>0.05）； holmium laser ablation group of urethral stricture， dysuria and other complication rates were lower than those in the resection group （P<0.05）. Among them， there were 3 cases of urethral stricture， 3 cases of dysuria and 2 cases of hemorrhage in the resection group， the incidence was 21.05%. One case of urethral stricture with holmium laser had a urethral stricture， the incidence rate was 2.63%. The volume of hemorrhage， bladder irrigation time and catheterization time were（97.10±20.34）mL， （24.16±18.25）h and （1.62±0.38）d， respectively， which were better than the control group（130.55±24.52）mL，（48.86±20.46）h and（2.45±1.34）d，（P<0.05）. Conclusion Transurethral resection of transhepatic holmium laser for the treatment of benign prostatic hyperplasia in the elderly and transurethral resection of the prostate can improve the clinical symptoms and improve the urination， but the transurethral resection of the prostate has higher safety， can reduce surgical trauma， reduce bleeding， reduce complications， accelerate postoperative rehabilitation.

相關(guān)熱詞搜索：前列腺 尿道 療效 激光 老年