Abstract:

Objective　To investigate the safety and clinical efficacy of green laser prostatic enucleage in the treatment of patients with benign prostatic hyperplasia by comparison between the holmium laser, green laser, and bipolar plasma therapies for benign prostatic hyperplasia. Methods　In this prospective study, 90 patients who were hospitalized in Yangjiang Hospital of Traditional Chinese Medicine from October 2019 to December 2021 were selected; they were 64-90 years old, with an average of 78. According to the treatment methods, they were divided into a transurethral green laser prostatic enucleage group, a transurethral holmium laser prostatic enucleage group, and a transurethral bipolar plasma prostatic enucleage group, with 30 cases in each group. The hemoglobin, maximum urine flow rate, residual urine, international prostate symptom score, and quality of life score were measured before and after the surgery. The postoperative adverse reactions, lengths of indwelling urinary catheter, hospital stays, and occurrence of recent complications were recorded. The χ² and t tests were used. Results　The operation time, hemoglobin decrease during the operation, length of indwelling urinary catheter after the operation, bladder lavage time, and hospital stay were (50.5±14.3) min, (6.0±4.9) g/L, (80.1±17.5) h, 0, and (7.6±1.3) d in the transurethral green laser prostatic enucleage group, were (72.3±16.9) min, (10.5±4.5) g/L, (87.1±18.5) h, (20.0±4.6) h, and (8.1±1.2) d in the transurethral holmium laser prostatic enucleage group, and were (66.5±14.3) min, (7.7±3.4) g/L, (84.3±17.4) h, (17.0±4.3) h, and (7.4±1.0) d in the transurethral bipolar plasma prostatic enucleage group; those in the transurethral green laser prostatic enucleage group were better than those in the other two groups, with statistical differences (all P<0.01). Threes cases had complications after the surgery in the transurethral green laser prostatic enucleage group, 8 in the transurethral holmium laser prostatic enucleage group, and 5 in the transurethral bipolar plasma prostatic enucleage group, with no statistical difference (P>0.05). Conclusion　Transurethral green laser prostatic enucleage has the characteristics of precise curative effect, less bleeding, and fast recovery, and can be used as the first choice for the surgical treatment of prostatic hyperplasia.

Key words:

Prostatic hyperplasia, Holmium laser, Green laser, Tissue crusher, Quick and comfortable recovery

摘要：

目的　通过钬激光、绿激光、双极等离子治疗良性前列腺增生的对比分析，探讨绿激光前列腺剜除的安全性及临床疗效。方法　采用前瞻性方法，选取2019年10月至2021年12月期间在阳江市中医医院接受住院治疗的90例良性前列腺增生患者，年龄范围64～90岁，平均78岁。按治疗方法不同分为经尿道绿激光前列腺剜除术组、经尿道钬激光前列腺剜除术组与经尿道等离子前列腺剜除术组，各30例。手术前后检测血红蛋白、最大尿流率、残余尿、国际前列腺症状评分、生活质量评分，记录术后不良反应、留置尿管时间、住院时间及近期并发症发生情况。采用χ²检验、t检验进行统计分析。结果　经尿道绿激光前列腺剜除术组手术时间、术中血红蛋白下降、术后留置尿管时间、膀胱持续灌洗时间及住院天数分别为（50.5±14.3）min、（6.0±4.9）g/L、（80.1±17.5）h、0、（7.6±1.3）d，经尿道钬激光前列腺剜除术组分别为（72.3±16.9）min、（10.5±4.5）g/L、（87.1±18.5）h、（20.0±4.6）h、（8.1±1.2）d，经尿道等离子前列腺剜除术组分别为（66.5±14.3）min、（7.7±3.4）g/L、（84.3±17.4）h、（17.0±4.3）h、（7.4±1.0）d，经尿道绿光前列腺剜除术患者上述项目均明显优于其他两组，差异均有统计学意义（均P<0.01）。经尿道绿激光前列腺剜除术组、经尿道钬激光前列腺剜除术组与经尿道等离子前列腺剜除术组术后并发症分别发生3例、8例、5例，差异无统计学意义（P>0.05）。结论　经尿道进行绿激光前列腺剜除术具有疗效确切、出血少、恢复快的特点，可作为前列腺增生外科治疗的首选术式。

关键词:

前列腺增生, 钬激光, 绿激光, 组织粉碎器, 快速舒适康复