Shao Qiang, Zhang Feng-Bo, Shang Dong-Hao, Tian Ye
Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Nan Ke Xue. 2009 Apr;15(4):346-9.
To investigate and compare the effect and safety of Holmium laser and Thulium laser in transurethral enucleation of the prostate in BPH patients.
Ninety-eight BPH patients were divided into 2 groups and underwent transurethral enucleation of the prostate with holmium laser (Ho group) and thulium laser (Th group) respectively. Comparisons were made between the 2 groups in operation time, bleeding volume, electrolyte, IPSS score, PVR and Qmax.
No statistically significant differences were noted between the 2 groups in age and preoperative prostate volume, IPSS, PVR and Qmax (P > 0.05). The mean operation time was shorter in the Th group ([84.6 +/- 10.2] min) than in the Ho group ([70.5 +/- 7.5] min) (P = 0.032); blood loss was less in the former ([126.5 +/- 14.6] ml) than in the latter ([176.5 +/- 14.1] ml) (P = 0.071), with no blood transfusion necessitated; and the mean times of catheter indwelling were 2.4 d and 2.5 d respectively. There were no significant differences in the levels of hemoglobin and electrolyte before and after operation between the two groups, and no TURP syndrome was observed. IPSS, PVR and Qmax before operation were significantly different from those obtained 3 months after it (P < 0.05) in both the groups, but none of the indexes exhibited statistically significant differences when compared in the same period (P > 0.05).
Both holmium and thulium laser transurethral enucleation of the prostate can alleviate LUTS in BPH patients with similar short-time effectiveness. Thulium is superior to holmium laser in hemostasis, but inferior to it in anatomical distinctness.
探讨并比较钬激光与铥激光在良性前列腺增生(BPH)患者经尿道前列腺剜除术中的疗效及安全性。
98例BPH患者分为2组,分别接受钬激光(钬组)和铥激光(铥组)经尿道前列腺剜除术。比较两组的手术时间、出血量、电解质、国际前列腺症状评分(IPSS)、残余尿量(PVR)及最大尿流率(Qmax)。
两组患者在年龄、术前前列腺体积、IPSS、PVR及Qmax方面差异无统计学意义(P>0.05)。铥组平均手术时间短于钬组([84.6±10.2]分钟 vs [70.5±7.5]分钟,P = 0.032);前者出血量少于后者([126.5±14.6]毫升 vs [176.5±14.1]毫升,P = 0.071),无需输血;平均留置导尿管时间分别为2.4天和2.5天。两组患者术后血红蛋白及电解质水平与术前相比差异无统计学意义,未观察到经尿道前列腺电切综合征(TURP综合征)。两组患者术前IPSS、PVR及Qmax与术后3个月时相比差异有统计学意义(P<0.05),但同期比较各项指标差异无统计学意义(P>0.05)。
钬激光和铥激光经尿道前列腺剜除术均可缓解BPH患者的下尿路症状(LUTS),短期疗效相似。铥激光在止血方面优于钬激光,但在解剖清晰度方面不如钬激光。