经尿道前列腺绿激光剜除术与前列腺电切术治疗前列腺增生症效果对比分析

文爽; 杨林; 罗军; 熊波; 王洪志; 张成果; 王亚荣; 郑昌建

doi:10.16016/j.1000-5404.202004032

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经尿道前列腺绿激光剜除术与前列腺电切术治疗前列腺增生症效果对比分析

临床医学 | 更新时间：2026-01-09

- 经尿道前列腺绿激光剜除术与前列腺电切术治疗前列腺增生症效果对比分析
- Comparison of therapeutic effects of green laser enucleation of the prostate and transurethral prostate resection for treatment of benign prostatic hyperplasia
- 第三军医大学学报 2020年42卷第18期页码：1868-1874
- 作者机构：
  
  402760 重庆，重庆市璧山区人民医院泌尿外科
- 作者简介：
  
  [ 杨林，E-mail:284835248@qq.com YANG Lin, E-mail:284835248@qq.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202004032
  中图分类号： R697.32; R699.8
- 收稿：2020-04-03，
  
  修回：2020-05-21，
  
  纸质出版：2020-09-30
- 稿件说明：
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文爽, 杨林, 罗军, 等. 经尿道前列腺绿激光剜除术与前列腺电切术治疗前列腺增生症效果对比分析[J]. 第三军医大学学报, 2020,42(18):1868-1874.

Shuang WEN, Lin YANG, Jun LUO, et al. Comparison of therapeutic effects of green laser enucleation of the prostate and transurethral prostate resection for treatment of benign prostatic hyperplasia[J]. Journal of Third Military Medical University, 2020, 42(18): 1868-1874.
文爽, 杨林, 罗军, 等. 经尿道前列腺绿激光剜除术与前列腺电切术治疗前列腺增生症效果对比分析[J]. 第三军医大学学报, 2020,42(18):1868-1874. DOI： 10.16016/j.1000-5404.202004032.

Shuang WEN, Lin YANG, Jun LUO, et al. Comparison of therapeutic effects of green laser enucleation of the prostate and transurethral prostate resection for treatment of benign prostatic hyperplasia[J]. Journal of Third Military Medical University, 2020, 42(18): 1868-1874. DOI： 10.16016/j.1000-5404.202004032.

摘要

目的

对比分析经尿道前列腺绿激光剜除术(green laser enucleation of prostate，GreenLEP)与经尿道前列腺电切术(transurethral resection of the prostate，TURP)治疗良性前列腺增生症(benign prostatic hyperplasia，BPH)的效果。

方法

回顾性分析本院2017年2月至2018年11月收治的BPH患者104例，分别接受绿激光剜除术(GreenLEP组，52例)和电切术(TURP组，52例)治疗，评测两组患者手术时间、术中出血量、手术切除的前列腺体积以及术后膀胱冲洗时间、术后尿管留置时间、住院时间等相关指标，并比较手术前及手术后1、6个月的前列腺症状评分(IPSS)、生活质量(QoL)、最大尿流率(Qmax)、剩余尿量(PVR)、前列腺特异性抗原(PSA)、前列腺体积(PV)等指标。

结果

两组患者术后的Qmax、QoL、PVR、PSA、PV、IPSS和IIEF指标均较术前明显改善(

0.001)。GreenLEP组的Qmax[(22.03±3.01)

(19.08±2.62)mL/s，

0.001

]

和IPSS评分[(5.35±1.67)

(7.92±2.19)，

0.001

]

优于TURP组，但两组QoL、PVR、PSA、PV等差异无统计学意义。手术安全性比较：GreenLEP组在 PV≤60 mL(较小体积) 时术后膀胱冲洗时间优于 TURP 组[(18.88±2.36)

(34.33 ±2.90)h，

0.001

]

；GreenLEP组在前列腺中等体积(60mL

80mL)时术中出血量[(63.30±4.27)

(77.28±6.19)mL，

0.001

]

、术后膀胱冲洗时间[(23.11±1.91)

(41.56±3.15)h，

0.001

]

、术后住院时间[(3.07±0.61)

(3.88±0.88)d，

0.001

]

均优于TUPR组，而两组手术时间及前列腺切除体积差异无统计学意义；GreenLEP组在PV≥80 mL(较大体积)时，在所有监测指标上均优于TURP组(

0.001)。GreenLEP组术后一过性尿失禁发生率高于TURP组，而GreenLEP术后低钠血症、性功能障碍、电切综合征发生率及术后输血率显著低于TURP组，差异均有统计学意义(

0.05)。

结论

GreenLEP治疗BPH患者与TURP效果相当，在减少术中出血、术后膀胱冲洗时间、术后住院时间及降低术后并发症发生率上有明显优势，可能更加适合前列腺体积较大的患者。

Abstract

Objective

To evaluate the therapeutic effect of green laser enucleation of the prostate (GreenLEP) and transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia (BPH).

Methods

From February

2017 to November

2018

104 patients with BPH were treated with either GreenLEP (52 cases) or TURP (52 cases) in our hospital. The operation time

intraoperative bleeding volume

resected prostate volume

postoperative bladder irrigation time

postoperative catheter indwelling time and hospitalization time as well as the international prostate symptom scores (IPSS)

quality of life (QoL)

maximum flow rate (Qmax)

postvoid residual urine volume (PVR)

prostate specific antigen (PSA)

and prostate volume (PV) before and at 1 month and 6 months after the operation were compared between the 2 groups.

Results

The symptoms and quality of life of the patients improved significantly after the operation in both groups. Compared with those in TURP group

the patients in GreenLEP group had better postoperative Qmax (22.03±3.01

19.08±2.62 mL/s

0.001) and IPSS (5.35±1.67

7.92±2.19

0.001) with similar QoL

PVR

PSA

and PV. In patients with a PV no greater than 60 mL

the postoperative bladder irrigation time was significantly shorter in GreenLEP group than in TURP group (18.88±2.36

34.33±2.90 h

0.001). In patients with a PV of 60-80 mL

compared with the TURP group

the GreenLEP group had significantly less intraoperative blood loss (63.30±4.27

77.28±6.19 mL

0.001) and shorter postoperative bladder irrigation time (23.11±1.91

41.56±3.15 h

0.001) and postoperative hospital stay (3.07±0.61

3.88±0.88 days

0.001) without significant differences in the operation time or prostatectomy volume. In patients with a PV beyond 80 mL

the assessed parameters in GreenLEP group were all superior to those in TURP group (

0.001). The GreenLEP group recorded a significantly higher incidence of postoperative transient urinary incontinence but lower incidences of postoperative hyponatremia

sexual dysfunction

electrocut syndrome and posto

perative blood transfusion than TURP group (

0.05).

Conclusion

For treatment of BPH

GreenLEP has similar therapeutic effect to TURP

but GreenLEP is associated with reduced intraoperative bleeding

shorter postoperative bladder irrigation time and postoperative hospital stay and lowered incidences of postoperative complications especially in patients with a large PV.

关键词

Keywords

references

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