持续负压吸引预防前列腺电切术相关并发症的作用研究

目的探讨在连续灌洗型电切镜行经尿道前列腺电切术中应用持续负压吸引预防手术相关并发症的有效性。方法将200例前列腺增生患者随机分成观察组及对照组各100例,均采用连续灌洗型电切镜行前列腺电切术,观察组:出水口接持续负压吸引,以腹腔穿刺针行耻骨上膀胱穿刺持续测量膀胱内压,常规行前列腺电切术,记录膀胱内压、手术时间、是否发生电切综合征和膀胱痉挛,术后常规复查血常规。对照组:出水口不接负压吸引,监测相同项目;将统计结果对比分析。结果 200例均手术成功,均无明显前列腺包膜穿孔发生,观察组100例:膀胱内压平均10 cm H2O,手术时间平均70.0 min,术后HGB下降值为25 g/L,发生7例前列腺包膜小穿孔,1例(1%)电切综合征,2例(2%)膀胱痉挛。对照组100例:膀胱内压平均38 cm H2O,手术时间平均82.0 min,术后HGB下降值为32 g/L,发生8例前列腺包膜小穿孔,6例(6%)电切综合征,8例(8%)膀胱痉挛。具有显著性差异(p<0.05)。结论在连续灌洗型电切镜行经尿道前列腺电切术中应用持续负压吸引能缩短手术时间,减少电切综合征及膀胱痉挛两大并发症的发生率,使手术更安全,方法简单易行,适合推广应用。

RESEARCH THE ROLE OF CONTINUOUS SUCTION TO PREVENT THE RELATED COMPLICATIONS OF PROSTATE TRANSURETHRAL RESECTION

Objective To investigate the effectiveness of application of continuous suction to prevent the surgery - related complications in continuous lavage resectoscope transurethral prostate resection. Methods 200 ca- ses of patients with benign prostatic hyperplasia were randomly divided into observation group and the control group, 100 cases in each. All used continuous lavage resectoscope to do transurethral prostate resection. Observation group： outlet connected to continuous suction, use abdominal puncture needle to puncture the bladder above the pubis to measuring the intravesical pressure continually, conventionally to do transurethral prostate resection, record the intra- vesical pressure, operative time, whether there was TURS bladder spasm after the operation, review the routine of blood. Control group： outlet do not connected to continuous suction, monitoring of the same project, comparatively analyze the statistical results. Results 200 cases surgery were successful, there was no significant prostatic capsule perforation. 100 cases of the observation group： the average intravesical pressure was 10 cmn20, the mean operation time was 70 minutes, HGB decreased after the surgery of 25 g/L, occurrence of 7 cases with small perforation of the prostate capsule, 1 （ 1% ） TURS, 2 patients （2%） bladder spasm. 100 cases of the control group： the average intra- vesical pressure was 38 cmH20, the mean operation time was 82 minutes, HGB decreased after the surgery of 32 g/L, occurrence of 8 cases with small perforation of the prostate capsule, 6 （6%） TURS, 8 patients （8%） blad- der spasm. Having a significant difference（p 〈 0.05）. Conclusion Application of continuous suction to prevent the surgery - related complications in continuous lavage resectoscope transurethral prostate resection can shorten the oper- ation time, reduce the incidence of the two major complications TURS and bladder spasm, make surgery safer, the method is simple, suitable for popularization and application.