目的 探讨半导体激光剜除术对前列腺增生患者尿动力学、血清睾酮、前列腺特异抗原(PSA)水平的影响.方法 前瞻性选取2021年2月至2023年2月在大庆龙南医院就诊的90例前列腺增生患者作为研究对象,按随机数字表法将其分为观察组与对照组,每组各45例.观察组行半导体激光剜除术,对照组行前列腺电切术.比较两组围手术期指标、术后并发症及手术前后的残余尿量(PVR)、最大尿流率(Qmax)、睾酮、PSA、国际前列腺症状评分(IPSS)、生活质量量表(QOL).结果 观察组的手术时间、术中出血量、术后膀胱冲洗时间、术后留置导管时间、住院时间分别为(69.88±10.26)min、(40.23±6.28)mL、(20.04±5.19)h、(2.96±0.81)d、(4.29±1.12)d,均显著少于对照组[(77.76±9.74)min、(64.11±8.75)mL、(27.83±8.34)h、(4.61±1.51)d、(6.02±1.45)d],差异均有统计学意义(P<0.05).两组术后残余尿量均较术前显著降低,Qmax均较术前显著升高,观察组残余尿量为(9.04±2.37)mL,低于对照组[15.08±4.24)mL],Qmax为(26.97±8.02)mL/s,高于对照组[(18.55±7.23)mL/s],差异均有统计学意义(P<0.05).两组术后血清睾酮、PSA水平均较术前显著降低,观察组血清睾酮、PSA水平分别为(18.71±1.04)mmol/L、(4.36±1.08)ng/mL,均低于对照组[(21.05±1.15)mmol/L、(8.08±1.69)ng/mL],差异均有统计学意义(P<0.05).两组术后IPSS、QOL评分均较术前显著降低,观察组IPSS、QOL评分分别为(6.10±1.25)、(1.23±0.29)分,均低于对照组[(8.23±1.31)、(1.77±0.56)分],差异均有统计学意义(P<0.05).观察组术后并发症总发生率为13.33%,显著低于对照组(31.11%),差异有统计学意义(P<0.05).结论 半导体激光剜除术在改善前列腺增生患者尿动力学及血清睾酮、PSA水平等方面效果优于前列腺电切术.
Objective To investigate the effects of laser enucleation on urodynamics,serum testosterone and prostate specific antigen(PSA)levels in patients with hyperplasia of prostate.Methods A total of 90 patients with hyperplasia of prostate admitted to Daqing Longnan Hospital from February 2021 to February 2023 were included in the study,and were divided into the observation group and the control group ac-cording to the random number table method,with 45 cases in each group.The observation group underwent semiconductor laser enucleation,while the control group underwent electroprostatectomy.Perioperative indexes,postoperative complications,residual urine volume,maximum urine flow rate(Qmax),testosterone,PSA,International Prostate Symptom Score(IPSS),Quality of Life scale(QOL)before and after surgery were com-pared between the two groups.Results The Operation time,intraoperative blood loss,postoperative bladder irrigation time,postoperative catheter indignant time and hospital stay in the observation group were(69.88±10.26)min,(40.23±6.28)mL,(20.04±5.19)h,(2.96±0.81)d,(4.29±1.12)d,which were significantly less than those in the control group[(77.76±9.74)min,(64.11±8.75)mL,(27.83±8.34)h,(4.61±1.51)d,(6.02±1.45)d],the differences were statistically significant(P<0.05).After surgery,residual urine volume in the two groups were significantly lower than those before surgery,Qmax in the two groups were significantly higher than those before surgery,and resid-ual urine volume in the observation group was(9.04±2.37)mL,which was lower than that in the control group[(15.08±4.24)mL],while Qmax was(26.97±8.02)mL/s,which was higher than that in the control group[(18.55±7.23)mL/s],the differences were statistically sig-nificant(P<0.05).After surgery,the levels of serum testosterone and PSA in the two groups were significantly lower than those before surgery,and the levels of serum testosterone and PSA in the observation group were(18.71±1.04)mmol/L,(4.36±1.08)ng/mL,which were signifi-cantly lower than those in the control group[(21.05±1.15)mmol/L,(8.08±1.69)ng/mL],the differences were statistically significant(P<0.05).After surgery,IPSS and QOL scores of the two groups were significantly lower than those before surgery,and the IPSS and QOL scores of the observation group were(6.10±1.25)and(1.23±0.29)points,respectively,which were lower than those of the control group[(8.23 ±1.31)and(1.77±0.56)points],and the differences were statistically significant(P<0.05).The total incidence of postoperative compli-cations in the observation group was 13.33%,which was significantly lower than that in the control group(31.11%),and the difference was sta-tistically significant(P<0.05).Conclusion Semiconductor laser enucleation is better than electroprostatectomy in improving urodynamics and serum testosterone and PSA levels in patients with hyperplasia of prostate.