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中华养生保健 ›› 2023, Vol. 41 ›› Issue (19): 4-7.

• 论著 • 上一篇    下一篇

不同途径前列腺穿刺后的BPH患者行经尿道前列腺钬激光剜除术的疗效比较

王选锋1,2, 汪雄3, 葛庆宇1, 陶陶2,*   

  1. 1.安徽中医药大学附属滁州市中西医结合医院泌尿外科,安徽 滁州,239000;
    2.中国科学技术大学附属第一医院(安徽省立医院)泌尿外科,安徽 合肥,230001;
    3.皖南医学院研究生院,安徽 芜湖,241000
  • 出版日期:2023-10-01 发布日期:2023-09-20
  • 通讯作者: *陶陶,E-mail:taotao860721@126.com。
  • 作者简介:王选锋(1989—),男,汉族,籍贯:安徽省滁州市,本科,主治中医师,研究方向:泌尿外科。
  • 基金资助:
    国家自然科学基金(81702540); 安徽省自然科学基金(1708085QH202); 滁州市临床重点专科项目(2022227号)

Comparison of the Therapeutic Effect of Transurethral Holmium Laser Enucleation in Patients with BPH after Transrectal or Transperineal Prostate Biopsy

WANG Xuan-feng1,2, WANG Xiong3, GE Qing-yu1, TAO Tao2,*   

  1. 1. Department of Urology, Chuzhou Hospital of Combined Traditional Chinese and Western Medicine, Anhui University of Traditional Chinese Medicine, Chuzhou Anhui 239000, China;
    2. Department of Urology, The First Hospital Affiliated to the University of Science and Technology of China (Anhui Provincial Hospital), Hefei Anhui 230001, China;
    3. Graduate School of Wannan Medical College, Wuhu Anhui 241000, China
  • Online:2023-10-01 Published:2023-09-20

摘要: 目的 观察分析血清PSA异常的经直肠和经会阴两种不同途径前列腺穿刺后诊断为前列腺增生(BPH)患者行经尿道前列腺钬激光剜除术(HoLEP)的安全性和有效性。方法 回顾性分析2018年1月—2020年6月在中国科学技术大学附属第一医院(安徽省立医院)接受HoLEP治疗的60例前列腺穿刺后BPH患者的临床资料,依据前列腺穿刺活检路径将患者分为经会阴组(29例)与经直肠组(31例),收集两组患者的基线资料、围手术期指标及术后3个月、6个月的随访情况数据来分析两组之间的差异。结果 经直肠组的手术时长、术后导尿时间长于经会阴组,差异有统计学意义(P<0.05)。经会阴组术后总并发症发生率低于经直肠组,差异有统计学意义(P<0.05)。两组患者术后3个月、6个月的国际前列腺症状评分(IPSS)、前列腺症状生活质量评分(QOL)及最大尿流率(Qmax)比较,差异无统计学意义(P>0.05)。结论 经会阴或经直肠前列腺穿刺活检后3周左右的BPH患者行HoLEP治疗疗效确切且安全;经会阴穿刺后的BPH患者行HoLEP治疗与经直肠组比较,手术时间及留置导尿时间更短,手术后出现并发症的概率更小。

关键词: 良性前列腺增生, 经直肠前列腺穿刺, 经会阴前列腺穿刺, 经尿道前列腺钬激光剜除术

Abstract: Objective To observe and analyze the safety and effectiveness of transurethral holmium laser enucleation of the prostate (HoLEP) in patients with BPH after transrectal or transperineal prostate biopsy. Methods The data of 60 BPH patients who underwent HoLEP in the Department of Urology, First Affiliated Hospital of USTC(Anhui Provincial Hospital) from January 2018 to June 2020 were collected. All the patients are diagnosed by prostate biopsy and divided into transperineal group and transrectal group according to the operational approach.There were 29 cases in the transperineal group and 31 cases in the transrectal group. The basic information, perioperative indicators and follow-up data of 3 and 6 months after surgery were collected and analyzed. Results The length of surgery and postoperative catheterization time in the transrectal group was longer than that in the transperineal group, and the difference was statistically significant (P<0.05). The overall postoperative complication rate was lower in the transperineal group than in the transrectal groupthe transperineal group, the difference between the two groups was statistically significant (P<0.05). Comparison of the International Prostate Symptom Score (IPSS), Quality of Life Score (QOL) for prostate symptoms and maximal urinary flow rate (Qmax) of patients in the two groups at 3 and 6 months postoperatively, the difference was not statistically significant (P>0.05). Conclusion HoLEP treatment for BPH patients at 3 weeks after transperineal or transrectal prostate biopsy is effective and safe. In the patients who underwent HoLEP after transperineal biopsy, the operation time and indwelling catheterization time are shorter and has fewer complications postoperatively.

Key words: benign prostatic hyperplasia, transrectal prostate biopsy, transperineal prostate biopsy, transurethral holmium laser enucleation of the prostate

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