经尿道前列腺钬激光剜除术与经尿道前列腺电切术治疗老年良性前列腺增生症疗效比较分析

　　[摘要] 目的 探討经尿道前列腺钬激光剜除术与经尿道前列腺电切术治疗老年良性前列腺增生症疗效。方法 方便选取2015年5月—2016年5月76例老年良性前列腺增生症患者作为研究对象，根据方法分组，各有38例。电切组采用经尿道前列腺电切术治疗，钬激光剜除组采用经尿道前列腺钬激光剜除术治疗。比较两组老年良性前列腺增生症治疗总有效率；术中出血量、冲洗膀胱时间、尿管置管时间；患者残留尿量、IPSS评分、最大尿流率；尿道狭窄、排尿困难等并发症发生率。结果 钬激光剜除组老年良性前列腺增生症治疗总有效率94.74%和电切组92.11%之间差异无统计学意义（P>0.05）；两组残留尿量、IPSS评分、最大尿流率相近，其中，钬激光剜除组（17.24±3.20）mL、（1.24±0.74）分和（21.14±5.41）mL/s，电切组（16.41±3.24）mL、（1.25±0.47）分、（21.24±5.89）mL/s（P>0.05）；钬激光剜除组尿道狭窄、排尿困难等并发症发生率低于电切组（P<0.05）。其中，电切组有3例出现尿道狭窄，3例出现排尿困难，2例出血，发生率21.05%；钬激光剜除组有1例出现尿道狭窄，发生率2.63%。钬激光剜除组术中出血量、冲洗膀胱时间、尿管置管时间（97.10±20.34）mL、（24.16±18.25）h、（1.62±0.38）d优于对照组（130.55±24.52）mL、（48.86±20.46）h、（2.45±1.34）d（P<0.05）。结论 经尿道前列腺钬激光剜除术治疗老年良性前列腺增生症疗效和经尿道前列腺电切术相当，均可有效改善患者临床症状，改善排尿情况，但其中以经尿道前列腺钬激光剜除术安全性更高，可减轻手术创伤，减少出血量，减少并发症，加速术后康复。
　　[关键词] 经尿道前列腺钬激光剜除术；经尿道前列腺电切术；老年良性前列腺增生症；疗效
　　[中图分类号] R4 [文献标识码] A [文章编号] 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.

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