不同功率HoLEP联合钬激光碎石术在治疗良性前列腺增生合并膀胱结石的疗效及安全性分析

doi:10.3969/j.issn.1006-6233.2024.10.018

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摘要 目的:研究不同功率钬激光前列腺剜除术(HoLEP)联合钬激光碎石术(HLC)在治疗良性前列腺增生(BPH)合并膀胱结石的疗效及安全性分析。方法:收集2019年1月至2024年1月丹阳市人民医院收治的110例BPH合并膀胱结石患者的临床资料,根据手术方式,将接受高功率HoLEP联合HLC的患者纳入HP组(n=62),接受低功率HoLEP联合HLC的患者纳入LP组(n=48)。比较两组围术期指标、排尿功能、应激指标、术后并发症。结果:HP组手术时间(68.49±15.36)min、剜除组织质量(41.42±10.59)g、膀胱冲洗时间(1.86±0.66)d、术后尿管留置时间(2.34±0.85)d与LP组[(70.15±15.71)min、(42.81±9.93)g、(1.81±0.72)d、(2.58±0.92)d]比较差异无统计学意义(P>0.05);HP组腺体剜除时间(35.80±7.21)min、住院时间(3.62±0.64)d短于LP组[(41.64±7.83)min、(3.86±0.50)d],剜除效率(1.15±0.25)g/min、血红蛋白下降幅度(8.05±1.58)g/L高于LP组[(1.02±0.18)g/min、(7.36±1.72)g/L],差异有统计学意义(P<0.05);术后3个月,HP组Qmax、PVR、PSA治疗前后差值与LP组比较差异无统计学意义(P>0.05);术后24h,HP组SP、PGE2、NE治疗前后差值与LP组比较差异无统计学意义(P>0.05);HP组术后并发症(12.88%)与LP组(10.40%)比较,差异无统计学意义(P>0.05)。结论:高功率、低功率HoLEP联合HLC对BPH合并膀胱结石的疗效相当,高功率HoLEP剜除效率更高,腺体剜除时间、住院时间更短,低功率HoLEP的止血效果更好。

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	夏东东
	曾明辉
	秦锁炳
	蒋东方

关键词 ：低功率钬激光前列腺剜除术, 高功率钬激光前列腺剜除术, 钬激光碎石术, 良性前列腺增生, 膀胱结石

Abstract：Objective: To study the efficacy and safety of different powers of holmium laser enucleation of the prostate (HoLEP) combined with holmium laser cystolithotripsy (HLC) in the treatment of benign prostatic hyperplasia (BPH) with bladder stones. Methods: The clinical data of 110 patients with BPH combined with bladder stones admitted to Danyang People's Hospital from January 2019 to January 2024 were collected. According to the surgical methods, patients who received high-power HoLEP combined with HLC were included in the HP group (n=62), and patients who adopted low-power HoLEP combined with HLC were enrolled as the LP group (n=48). Perioperative indicators, urinary function, stress indicators, and postoperative complications were compared between both groups. Results: The surgical time, excised tissue mass, bladder irrigation time and postoperative urinary catheter retention time with (68.49±15.36) min, (41.42±10.59) g (1.86±0.66) d and (2.34±0.85) d in the HP group were not statistically different form (70.15±15.71) min, (42.81±9.93) g, (1.81±0.72) d and (2.58±0.92) d in the LP group (P>0.05). The time of glandular enucleation and hospital stay with (35.80±7.21) min and (3.62±0.64) d in the HP group were shorter than (41.64±7.83) min and (3.86±0.50) d in the LP group, and the enucleation efficiency and decrease rate of hemoglobin with (1.15±0.25) g/min and (8.05±1.58) g/L were higher than (1.02±0.18) g/min and (7.36±1.72) g/L in the LP group (P<0.05). At 3 months after surgery, the differences of Qmax, PVR and PSA before and after treatment were not statistically significant between the HP group and the LP group (P>0.05). The differences of SP, PGE2 and NE before and after treatment revealed no statistical differences between the HP group and the LP group at 24 hours after surgery (P>0.05). There was no statistical significance in incidence of postoperative complications between the HP group (12.88%) and the LP group (10.40%) (P>0.05). Conclusion: High-power and low-power HoLEP combined with HLC have similar efficacy in the treatment of BPH with bladder stones. High-power HoLEP has higher enucleation efficiency, and shorter glandular enucleation time and hospital stay, and low-power HoLEP has better hemostatic effect.

Key words： Low-power holmium laser enucleation of the prostate High-power holmium laser enucleation of the prostate Holmium laser cystolithotripsy Benign prostatic hyperplasia Bladder stones

基金资助:江苏省卫生健康卫2023年度医学科研立项项目,(编号:H2023042)

通讯作者: 蒋东方

引用本文:

夏东东, 曾明辉, 秦锁炳, 蒋东方. 不同功率HoLEP联合钬激光碎石术在治疗良性前列腺增生合并膀胱结石的疗效及安全性分析[J]. 河北医学, 2024, 30(10): 1680-1684.
XIA Dongdong, ZENG Minghui, QIN Suobing, et al. Efficacy and Safety Analysis of Different Power HoLEP Combined with Holmium Laser Lithotripsy in the Treatment of Benign Prostatic Hyperplasia with Bladder Stones. HeBei Med, 2024, 30(10): 1680-1684.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.10.018 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I10/1680

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