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TUPKP 与 HoLEP 治疗 70 岁以上良性前列腺增生患者的临床疗效比较:回顾性研究。

Comparison of Clinical Therapeutic Efficacy between TUPKP and HoLEP for Patients Aged 70 Years and Older with Benign Prostatic Hyperplasia: Retrospective Study.

机构信息

Department of Urology, The First Hospital of Nanchang, 330008 Nanchang, Jiangxi, China.

Urinary Specialized Subject, Kangde Hospital, 330199 Nanchang, Jiangxi, China.

出版信息

Arch Esp Urol. 2024 Jul;77(6):644-650. doi: 10.56434/j.arch.esp.urol.20247706.88.

Abstract

OBJECTIVE

The occurrence of prostate hyperplasia has increased remarkedly, especially in elderly patients; However, research on which surgical treatment is effective and safe for benign prostatic hyperplasia (BPH) in elderly people over 70 years old is limited. This study aimed to investigate the clinical efficacy and safety of transurethral plasma kinetic prostatectomy (TUPKP) and holmium laser enucleation of prostate (HoLEP) as a therapy for benign prostatic hyperplasia (BPH) in the elderly.

METHODS

A total of 148 patients with BPH admitted from December 2022 to December 2023 were chosen and divided into HoLEP (n = 74) and TUPKP (n = 74) groups according to the surgical operation. Perioperative related indexes, preoperative and postoperative international prostate symptom scores and life quality scores were compared between the two groups. The postoperative complications were also counted for the two groups.

RESULTS

The HoLEP group had lower intraoperative bleeding, mean operative time, catheter indwelling time and hospital stays than the TUPKP group ( < 0.001). Before treatment, no significant difference in prostate symptom scores was found between the two groups ( > 0.05). After treatment, the prostate symptom scores in the HoLEP group were significantly lower than those in the TUPKP group ( < 0.001). However, the maximum urinary flow rate was significantly higher ( < 0.001) and the residual urine volume was significantly lower ( < 0.001) in the HoLEP group than in the TUPKP group after operation. The complication rate in the TUPKP group was 25.66%, which was significantly higher than the 9.46% in the HoLEP group ( < 0.05). The life quality scores of the HoLEP group were higher than those of the TUPKP group ( < 0.001).

CONCLUSIONS

HoLEP for BPH therapy is effective and safe with low incidence of postoperative complications.

摘要

目的

前列腺增生的发病率显著增加,尤其在老年患者中;然而,对于 70 岁以上老年人良性前列腺增生(BPH)哪种手术治疗既有效又安全的研究有限。本研究旨在探讨经尿道等离子动力学前列腺切除术(TUPKP)和钬激光前列腺剜除术(HoLEP)治疗老年良性前列腺增生(BPH)的临床疗效和安全性。

方法

选取 2022 年 12 月至 2023 年 12 月收治的 148 例 BPH 患者,根据手术方式分为 HoLEP 组(n=74)和 TUPKP 组(n=74)。比较两组患者的围手术期相关指标、术前和术后国际前列腺症状评分和生活质量评分。并统计两组患者的术后并发症。

结果

HoLEP 组术中出血量、平均手术时间、导尿管留置时间和住院时间均低于 TUPKP 组(<0.001)。治疗前,两组前列腺症状评分无显著差异(>0.05)。治疗后,HoLEP 组前列腺症状评分明显低于 TUPKP 组(<0.001)。但术后 HoLEP 组最大尿流率明显高于 TUPKP 组(<0.001),残余尿量明显低于 TUPKP 组(<0.001)。TUPKP 组并发症发生率为 25.66%,明显高于 HoLEP 组的 9.46%(<0.05)。HoLEP 组生活质量评分高于 TUPKP 组(<0.001)。

结论

HoLEP 治疗 BPH 疗效确切,术后并发症发生率低。

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