1470 nm半导体激光前列腺剜除治疗大体积前列腺增生:前瞻性随机对照研究

张淼涛; 韩慧; 钟煜韡

doi:10.13201/j.issn.1001-1420.2021.07.003

1470 nm半导体激光前列腺剜除治疗大体积前列腺增生:前瞻性随机对照研究

- 惠州市第六人民医院泌尿外科(广东惠州, 516200)
基金项目:
惠州市科技计划项目(No:2019Y277)

详细信息

通讯作者: 张淼涛,E-mail:gjfgk56355@163.com

中图分类号: R697

收稿日期: 2020-08-11

Prostate enucleation with 1470 nm diode laser for the treatment of bulky prostatic hyperplasia:a prospective randomized controlled study

- Department of Urology, Sixth People's Hospital of Huizhou, Huizhou, Guangdong, 516200, China

More Information

Corresponding author: ZHANG Miaotao, E-mail: gjfgk56355@163.com

Received Date: 11 August 2020

摘要

摘要: 目的:探讨1470 nm半导体激光前列腺剜除术(DiLEP)治疗大体积前列腺增生(BPH)的疗效和安全性。方法:选择大体积(≥80 mL)BPH患者84例,按照随机数字表法分为两组,每组42例,接受1470 nm DiLEP为DiLEP组,接受经尿道前列腺电切术(TURP)为TURP组。比较两组手术时间、腺体切除质量、术中出血量等围手术相关指标,出院后对两组随访3个月,比较两组术前及术后3个月残余尿(PVR)、最大尿流率(Q_max)、生活质量(QOL)评分和国际前列腺症状评分(IPSS);并比较两组术后尿失禁、尿道狭窄等并发症的发生情况。结果:与TURP组比较,DiLEP组手术时间更短(P＜0.01)、术中出血量更少(P＜0.01),腺体切除质量更大(P＜0.01),术后膀胱冲洗时间、尿管留置时间更短(P＜0.01);术后3个月两组PVR、Q_max、QOL评分、IPSS评分均显著改善(P＜0.01),组间比较差异无统计学意义(P＞0.05);术后DiLEP组并发症发生率低于TURP组,差异有统计学意义(P＜0.05)。结论:1470 nm DiLEP手术所需时间短,切除腺体组织多、出血量少,术后膀胱冲洗时间短,导尿管留置时间短,术后并发症少,治疗大体积BPH效果显著,安全性好。
- 前列腺增生 /
- 1470nm半导体激光 /
- 前列腺剜除 /
- 经尿道前列腺电切
Abstract: Objective: To investigate the efficacy and safety of 1470 nm diode laser enucleation of prostate(DiLEP) in the treatment of benign prostatic hyperplasia(BPH).Methods: Eighty-four patients with large volume(≥80 mL) BPH were selected and divided into two groups according to the random number table method, with 42 patients in each group. DiLEP group received DiLEP, while transurethral resection of prostate(TURP) group received TURP. Operation time, mass of the excised gland, intraoperative blood loss and other perioperative indicators were compared between the two groups. After discharge, the two groups were followed up for 3 months, and the postvoid residual volume(PVR), maximum urine flow rate(Q_max), quality of life(QOL) score and IPSS scores were compared between the two groups before and 3 months after operation. The incidence of postoperative complications such as urinary incontinence and urethral stricture was compared between the two groups.Results: Compared with the TURP group, DiLEP group had shorter operation time(P＜0.01), less intraoperative blood loss(P＜0.01), greater mass of the excised gland(P＜0.01), shorter postoperative bladder flushing time and urinary indwelling time(P＜0.01). Three months after surgery, PVR, Q_max, QOL scores and IPSS scores of the two groups significantly improved(P＜0.01), but the difference between the two groups was not statistically significant(P＞0.05). Incidence of postoperative complications in DiLEP group was lower than that in TURP group, and the difference was statistically significant(P＜0.05).Conclusion: Prostatic enucleation with 1470 nm diode laser has shorter operation time, more gland tissue excision and less intraoperative blood loss, shorter postoperative bladder irrigation time, shorter catheter indwelling time, and fewer postoperative complications. The treatment of bulky volume BPH is effective and safe.
- benign prostatic hyperplasia /
- 1470 nm diode laser /
- enucleation of prostate /
- transurethral resection of prostate

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参考文献(14)

[1]	米军,汪林军.大体积良性前列腺增生:选择何种术式?[J].中华男科学杂志,2019,25(5):387-391.
[2]	Yi QT,Gong M,Hu W,et al.Epidemic investigation of benign prostatic hyperplasia with coexisting overactive bladder in Shanghai Pudong New Area[J].J Modern Urol,2017,22(10):732-737.
[3]	陈一鸣,徐仁芳,经浩,等.经尿道前列腺低压电切术与经尿道钬激光前列腺剜除术治疗良性前列腺增生的对比研究[J].临床泌尿外科杂志,2020,35(11):874-877.
[4]	刘洪明,田野,苏志勇,等.前列腺总体积及移行带体积对良性前列腺增生症经尿道前列腺电切术疗效的影响[J].中华医学杂志,2021,101(2):137-141.
[5]	蒋吉高,董晓飞,金晓东.经尿道柱状水囊扩开术与经尿道前列腺等离子双极电切术治疗前列腺增生症的比较性研究[J].中国男科学杂志,2020,34(3):37-40.
[6]	Wu G,Hong Z,Li C,et al.A comparative study of diode laser and plasmakinetic transurethral enucleation of the prostate for treating large volum benign prostatic hyperplasia:a randomized clinical trial with 12-mon follow-up[J].Laser Med Sic,2016,31(4):134-139.
[7]	Das AK,Teplitsky S,Humphreys MR.Holmium laser enucleation of the prostate(HoLEP):a review and update[J].Can J Urol,2019,26(4 Suppl 1):13-19.
[8]	张俊飞,刘春,高杨杰,等.前列腺动脉栓塞术与经尿道前列腺电切术治疗前列腺增生的Meta分析[J].国际泌尿系统杂志,2020,40(2):243-249.
[9]	阴正坤,刘永胜.经尿道前列腺电切术与1470 nm半导体激光汽化术治疗前列腺增生的效果[J].中国性科学,2019,28(3):25-28.
[10]	秦松林,陈兵海,胡威,等.1470 nm双波长激光和等离子治疗良性前列腺增生的临床分析(附364例报告)[J].中国内镜杂志,2019,25(12):38-42.
[11]	Nnabugwu II,Ugwumba FO,Udeh EI,et al.Learning transurethral resection of the prostate:A comparison of the weight of resected specimen to the weight of enucleated specimen in open prostatectomy[J].Niger J Clin Pract,2017,20(12):1590-1595.
[12]	聂鹏敏,刘跃晖,李丹,等.激光及微创技术对良性前列腺增生症的研究进展[J].中国临床医生杂志,2020,48(7):790-793.
[13]	荆孝东.选择性半导体激光前列腺气化术治疗前列腺增生的近远期疗效[J].中华实用诊断与治疗杂志,2020,34(3):281-285.
[14]	王伟,潘铁军,高磊,等.半导体激光选择性增生腺体块状切除术与电切术治疗前列腺增生的比较[J/OL].中华腔镜泌尿外科杂志(电子版),2019,13(6):387-391.