铥激光前列腺汽化切除术与传统经尿道前列腺电切术疗效比较及术后尿道狭窄相关因素分析

发布时间：2018-12-14 03:33

【摘要】：目的:比较铥激光前列腺汽化切除术与经尿道前列腺电切术(TURP)术疗效及术后尿道狭窄相关因素分析。方法:收集2015年6月至2016年6月我院接受手术治疗的BPH患者210例,分为TURP组(n=126)和铥激光组(n=84),分别应用TURP和铥激光治疗,对比两种术式的治疗效果;术后随访半年,应用Logistic回归分析术后半年发生尿道狭窄的危险因素。结果:铥激光组患者的手术时间(53.2±21.6)min与TURP组患者(78.6±27.5)min相比明显缩短,术后膀胱冲洗时间(26.1±3.7)h与TURP组患者(31.5±2.9)h相比明显缩短,留置尿管时间(3.7±1.5)d与TURP组患者(5.3±1.7)d相比明显缩短,术后住院时间(5.5±1.4)d与TURP组患者(7.9±2.1)d相比也明显缩短,术后6个月尿白细胞铥激光组(24.9±11.7)个/μl较TURP组(32.1±12.6)个/μl更少,术后并发症发生率铥激光组(3.6%,3/84)较TURP组(11.9%,15/126)更低,其中尿道狭窄发生率铥激光组(1.2%,1/84)较TURP组(7.9%,10/126)明显更低,差异有统计学意义(P0.05);Logistic回归分析显示术前尿白细胞数、术后留置尿管时间、手术方式是术后尿道狭窄的独立危险因素。结论:铥激光手术相比TURP,疗效确切,术后恢复快,安全性高,术后尿道狭窄发生率低,术后尿道狭窄的主要风险因素有尿路感染、术后留置尿管时间及手术方式,应注意选择最佳术式、术后合理置管及预防尿道感染,从而减少尿道狭窄的发生。
[Abstract]:Objective: to compare the effect of thulium laser vaporization of prostate with transurethral resection of prostate (TURP) and the related factors of postoperative urethral stricture. Methods: from June 2015 to June 2016, 210 patients with BPH were divided into TURP group (n = 126) and thulium laser group (n = 84). They were treated with TURP and thulium laser respectively. Logistic regression analysis was used to analyze the risk factors of urethral stricture. Results: the operative time of thulium laser group (53.2 卤21.6) min was significantly shorter than that of TURP group (78.6 卤27.5) min. Postoperative bladder irrigation time (26.1 卤3.7) h was significantly shorter than that of TURP group (31.5 卤2.9) h, and the time of indwelling urinary catheter was (3.7 卤1.5) days shorter than that of TURP group (5.3 卤1.7) days. The postoperative hospitalization time (5.5 卤1.4) days was significantly shorter than that in the TURP group (7.9 卤2.1) days. The urinary leukocyte thulium laser group (24.9 卤11.7) / 渭 l was less than the TURP group (32.1 卤12.6) / 渭 l at 6 months after operation. The incidence of postoperative complications in the thulium laser group (3.6 / 84) was lower than that in the TURP group (11.915 / 126), and the incidence of urethral stricture in the thulium laser group (1.2 / 84) was higher than that in the TURP group (7.9%). 10 / 126) was significantly lower, the difference was statistically significant (P0.05). Logistic regression analysis showed that the number of urinary leukocytes before operation, the time of indwelling urinary catheter after operation and the operation mode were independent risk factors of postoperative urethral stricture. Conclusion: thulium laser surgery is more effective than TURP, in the treatment of urethral stricture. The postoperative recovery is faster, the safety is high, the incidence of postoperative urethral stricture is low. The main risk factors of postoperative urethral stricture are urinary tract infection, the time of indwelling urethral catheter and the operation mode. In order to reduce urethral stricture, we should choose the best operation method, place tube properly and prevent urethral infection.
【作者单位】：华中科技大学同济医学院附属同济医院泌尿外科;
【分类号】：R699

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