【摘要】：目的:比較銩激光前列腺汽化切除術(shù)與經(jīng)尿道前列腺電切術(shù)(TURP)術(shù)療效及術(shù)后尿道狹窄相關(guān)因素分析。方法:收集2015年6月至2016年6月我院接受手術(shù)治療的BPH患者210例,分為TURP組(n=126)和銩激光組(n=84),分別應(yīng)用TURP和銩激光治療,對比兩種術(shù)式的治療效果;術(shù)后隨訪半年,應(yīng)用Logistic回歸分析術(shù)后半年發(fā)生尿道狹窄的危險因素。結(jié)果:銩激光組患者的手術(shù)時間(53.2±21.6)min與TURP組患者(78.6±27.5)min相比明顯縮短,術(shù)后膀胱沖洗時間(26.1±3.7)h與TURP組患者(31.5±2.9)h相比明顯縮短,留置尿管時間(3.7±1.5)d與TURP組患者(5.3±1.7)d相比明顯縮短,術(shù)后住院時間(5.5±1.4)d與TURP組患者(7.9±2.1)d相比也明顯縮短,術(shù)后6個月尿白細(xì)胞銩激光組(24.9±11.7)個/μl較TURP組(32.1±12.6)個/μl更少,術(shù)后并發(fā)癥發(fā)生率銩激光組(3.6%,3/84)較TURP組(11.9%,15/126)更低,其中尿道狹窄發(fā)生率銩激光組(1.2%,1/84)較TURP組(7.9%,10/126)明顯更低,差異有統(tǒng)計學(xué)意義(P0.05);Logistic回歸分析顯示術(shù)前尿白細(xì)胞數(shù)、術(shù)后留置尿管時間、手術(shù)方式是術(shù)后尿道狹窄的獨立危險因素。結(jié)論:銩激光手術(shù)相比TURP,療效確切,術(shù)后恢復(fù)快,安全性高,術(shù)后尿道狹窄發(fā)生率低,術(shù)后尿道狹窄的主要風(fēng)險因素有尿路感染、術(shù)后留置尿管時間及手術(shù)方式,應(yīng)注意選擇最佳術(shù)式、術(shù)后合理置管及預(yù)防尿道感染,從而減少尿道狹窄的發(fā)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 鹵21.6) min was significantly shorter than that of TURP group (78.6 鹵27.5) min. Postoperative bladder irrigation time (26.1 鹵3.7) h was significantly shorter than that of TURP group (31.5 鹵2.9) h, and the time of indwelling urinary catheter was (3.7 鹵1.5) days shorter than that of TURP group (5.3 鹵1.7) days. The postoperative hospitalization time (5.5 鹵1.4) days was significantly shorter than that in the TURP group (7.9 鹵2.1) days. The urinary leukocyte thulium laser group (24.9 鹵11.7) / 渭 l was less than the TURP group (32.1 鹵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.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院泌尿外科;
【分類號】：R699

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