耻骨上前列腺切除术并发症的预防措施及效果观察

目的　探讨耻骨上前列腺切除术常见并发症的防治方法。方法　紧贴前列腺尖部捻断尿道 ,摘除前列腺后 ,采用腺窝口 5、7点处“8”字缝合 ,后唇及三角区粘膜下U字型沟槽状切除 ,将后唇粘膜缝入腺窝内的外科包膜上 ;术后 3d应用硬膜外腔接微量止痛泵持续注入吗啡、布比卡因、氟哌啶混合液 1ml/h止痛。结果　采用以上方法经治 5 4例 ,除 3例硬膜外导管脱出 ,1例止痛泵接点漏液外 ,5 0例术后无疼痛及膀胱痉挛。拔除尿管后 3例出现一过性尿失禁 ;4 2例随访 3个月～ 2年 ,37例排尿通畅 ,5例排尿困难 ,其中腺体残留 2例 ,尿道口狭窄 2例 ,后尿道狭窄 1例。结论　采用耻骨上前列腺切除可有效防治术后并发症的发生。

Preventive measure of common complications and therapeutic effect of suprapubic prostatectomy

Objective To explore the preventive measure of commor complications after suprapubic prostatectomy .Methods After suprapubic prostatectomy,figure-of-eight suture was performed at point 5 and point 7 of prostate fossa.Mucous membrane of the posterior lip and the pubourethral triangle was excised and moved to the external surgical membrane inside the prostate fossa.Three days after the operation 1ml/h mixtures of morphine, bipivicaine and droperidol were pumped into the epidural cavum to relieve pain.Results The above methods were applied to 54 cases of whom 50 cases were free from pain and vesical spasm.In 3 cases the catheter of epidural dropped out and leakage at joint point of the pump occurred in one case.The removal of the catheter led to urolepsia in 3 cases.of 42 cases followed up for 3 months to 2 years,3T cases wrrnated smoothly 5 cases had difficulty in urination iricluding 2 cases suffering from gland remaincler 2 cases suffering from stricture of urethral meatus and 1 cases suffering form posterrior.Conclusion Prostatectomy is proved to be effective in preventing and treating complications .