Abstract：
BACKGROUND: Transurethral holmium laser enucleation of the prostate (HoLEP) has a good therapeutic effect on benign prostatic hyperplasia (BPH). The purpose of this study was to investigate the clinical efficacy of HoLEP in the treatment of high-risk elderly patients with BPH and assess its impact on the inflammatory response, vascular endothelial function and quality of life (QoL).
METHODS: Patients at high risk of BPH who were hospitalised in Chengde Central Hospital from February 2021 to December 2022 were retrospectively selected as the study objects, and a total of 100 cases were included. The control group underwent transurethral resection of the prostate, and the observation group underwent HoLEP. Perioperative indexes, urodynamic indexes, QoL 6 months after surgery and incidence of postoperative complications were compared between the two groups. Moreover, serum levels of inflammatory factors and vascular endothelial factors were detected in two groups.
RESULTS: We found no significant difference in general data between the two groups of patients (p > 0.05). The operation time, perioperative bleeding, bladder flushing time and hospitalisation time of the observation group were significantly shorter than those of the control group (p < 0.05). On the 7th day after surgery, the serum levels of tumour necrosis factor alpha, interleukin-1β, interleukin-6, vascular endothelial growth factor, basic fibroblast growth factor and endothelin-1 in the observation group were significantly lower than those in the control group (p < 0.05). Six months after surgery, the maximal urinary flow rate and QoL scores of the patients in the observation group were significantly higher than those of the control group (p < 0.05), and the residual urine volume and International Prostate Symptom Score of observation group were significantly lower than those of the control group (p < 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (χ2 = 7.440, p = 0.006).
CONCLUSIONS: HoLEP can effectively remove hyperplasia of the prostate and reduce the inflammatory response in the patient\'s body when treating BPH in high-risk elderly patients. It can also regulate the levels of vascular endothelial factors and effectively improve the patient\'s QoL.
METHODS: Patients at high risk of BPH who were hospitalised in Chengde Central Hospital from February 2021 to December 2022 were retrospectively selected as the study objects, and a total of 100 cases were included. The control group underwent transurethral resection of the prostate, and the observation group underwent HoLEP. Perioperative indexes, urodynamic indexes, QoL 6 months after surgery and incidence of postoperative complications were compared between the two groups. Moreover, serum levels of inflammatory factors and vascular endothelial factors were detected in two groups.
RESULTS: We found no significant difference in general data between the two groups of patients (p > 0.05). The operation time, perioperative bleeding, bladder flushing time and hospitalisation time of the observation group were significantly shorter than those of the control group (p < 0.05). On the 7th day after surgery, the serum levels of tumour necrosis factor alpha, interleukin-1β, interleukin-6, vascular endothelial growth factor, basic fibroblast growth factor and endothelin-1 in the observation group were significantly lower than those in the control group (p < 0.05). Six months after surgery, the maximal urinary flow rate and QoL scores of the patients in the observation group were significantly higher than those of the control group (p < 0.05), and the residual urine volume and International Prostate Symptom Score of observation group were significantly lower than those of the control group (p < 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (χ2 = 7.440, p = 0.006).
CONCLUSIONS: HoLEP can effectively remove hyperplasia of the prostate and reduce the inflammatory response in the patient\'s body when treating BPH in high-risk elderly patients. It can also regulate the levels of vascular endothelial factors and effectively improve the patient\'s QoL.
摘要：
背景：经尿道钬激光前列腺摘除术（HoLEP）对良性前列腺增生（BPH）具有良好的治疗效果。目的探讨HoLEP治疗高危老年BPH患者的临床疗效,评估其对炎症反应的影响,血管内皮功能和生活质量(QoL)。
方法：回顾性选择2021年2月至2022年12月在承德市中心医院住院的BPH高危患者作为研究对象。共包括100例。对照组行经尿道前列腺电切术,观察组行HoLEP。围手术期指标,尿动力学指标，比较两组患者术后6个月的生活质量及术后并发症发生率。此外，检测两组血清炎症因子和血管内皮因子水平。
结果：我们发现两组患者的一般数据没有显着差异（p>0.05）。操作时间,围手术期出血,观察组膀胱冲洗时间和住院时间明显短于对照组(p<0.05)。手术后的第七天,血清肿瘤坏死因子α水平,白细胞介素-1β，白细胞介素-6,血管内皮生长因子,观察组碱性成纤维细胞生长因子和内皮素-1明显低于对照组(p<0.05)。手术后六个月,观察组患者的最大尿流率和QoL评分明显高于对照组(p<0.05),观察组的残余尿量和国际前列腺症状评分明显低于对照组(p<0.05)。观察组术后并发症发生率明显低于对照组(χ2=7.440,p=0.006)。
结论：HoLEP治疗高危老年BPH时，能有效清除前列腺增生，减轻患者体内炎症反应。它还可以调节血管内皮因子的水平,有效改善患者的生活质量。
方法：回顾性选择2021年2月至2022年12月在承德市中心医院住院的BPH高危患者作为研究对象。共包括100例。对照组行经尿道前列腺电切术,观察组行HoLEP。围手术期指标,尿动力学指标，比较两组患者术后6个月的生活质量及术后并发症发生率。此外，检测两组血清炎症因子和血管内皮因子水平。
结果：我们发现两组患者的一般数据没有显着差异（p>0.05）。操作时间,围手术期出血,观察组膀胱冲洗时间和住院时间明显短于对照组(p<0.05)。手术后的第七天,血清肿瘤坏死因子α水平,白细胞介素-1β，白细胞介素-6,血管内皮生长因子,观察组碱性成纤维细胞生长因子和内皮素-1明显低于对照组(p<0.05)。手术后六个月,观察组患者的最大尿流率和QoL评分明显高于对照组(p<0.05),观察组的残余尿量和国际前列腺症状评分明显低于对照组(p<0.05)。观察组术后并发症发生率明显低于对照组(χ2=7.440,p=0.006)。
结论：HoLEP治疗高危老年BPH时，能有效清除前列腺增生，减轻患者体内炎症反应。它还可以调节血管内皮因子的水平,有效改善患者的生活质量。
