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- 2016
TPKEP及HoLEP手术并发症的Clavien-Dindo分级评价及术后性功能比较
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Abstract:
摘要 目的:对比分析经尿道钬激光剜除术(HoLEP)和等离子剜除术(TPKEP)对前列腺增生症(BPH)手术并发症差异及术后性功能变化.方法:收集BPH患者166例,其中80例接受HoLEP(HoLEP组),86例接受TPKEP(TPKEP组),采用Clavien-Dindo手术并发症分级系统分析两组并发症情况,采用性功能主观感觉变化和IIEF-5评分评价两组术后性功能变化.结果:两组单项并发症发生率比较发现:HoLEP组延迟性血尿和尿路刺激症状发生率显著低于TPKEP组(P<0.05),HoLEP组术中膀胱黏膜损伤显著高于TPKEP组(P<0.05).HoLEP组和TPKEP组Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ级各级并发症发生率分别为:Ⅰ级 52.50%(42/80) vs 58.14%(50/86);Ⅱ级 16.25%(13/80) vs 17.44%(15/86);Ⅲ级 7.50%(6/80) vs 5.81%(5/86);Ⅳ级 2.50%(2/80) vs 3.49%(3/86);Ⅴ级 1.25%(1/80) vs 0.00%(0/80),两组比较无统计学差异(P>0.05).两组有少部分性功能改善患者,但术后IIEF-5评分总体上有所下降,两组术后性功能主观感觉变化及IIEF-5评分比较,无统计学差异(P>0.05).结论:HoLEP和TPKEP在并发症及术后性功能影响上无明显差异,少数患者术后性功能有改善,但总体上呈下降趋势.
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