膀胱造瘘术对于80 g以下良性前列腺增生症双极前列腺电切术患者围手术期的临床意义 |
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引用本文: | 龙其成,于哲,林光正,陈鹏亮,魏强,谭万龙.膀胱造瘘术对于80 g以下良性前列腺增生症双极前列腺电切术患者围手术期的临床意义[J].南方医科大学学报,2016,36(1):131-134. |
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作者姓名: | 龙其成 于哲 林光正 陈鹏亮 魏强 谭万龙 |
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作者单位: | 南方医科大学南方医院泌尿外科,广东 广州,510515 |
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摘 要: | 目的评估膀胱造瘘术对于80 g以下良性前列腺增生症(BPH)的患者行双极经尿道前列腺电切术(双极TURP)的围手术 期获益情况。方法收集南方医院2012年1月~2015年10月采用双极TURP治疗80 g以下BPH的病例资料进行回顾性分析。 根据双极TURP术中是否行膀胱造瘘术分为膀胱造瘘组和非膀胱造瘘组,比较两组之间的手术安全性、手术效率、并发症及护 理时间。结果符合纳入标准的病例共585例,其中膀胱造瘘组366例,非膀胱造瘘组219例。造瘘组和非造瘘组手术前后的血 钠浓度、血细胞比容及血红蛋白的下降量分别为0.06±2.92 mmol/L和0.54±3.64 mmol/L;(2.44±4.01)%和(2.89±4.05)%;9.62± 12.81 g/L 和10.42±8.31 g/L,两组间比较均无统计学差异(P>0.05)。两组的前列腺切除重量分别为42.50±12.39 g 和43.76± 12.23 g,两组间比较也无统计学差异(P>0.05)。而造瘘组具有更长的手术时间90.75±40.78 min vs 76.28±32.60 min,差异具有 统计学意义(P<0.05)。两组间的输血率、术后发热率及术后堵管率的比较无统计学差异(P>0.05)。与非造瘘组相比,造瘘组具 有更长的膀胱冲洗时间、尿管留置时间及术后住院时间,分别为3.15±1.44 d vs 2.57±0.89 d;5.19±1.41 vs 4.15±1.13 d;7.36± 2.09 d vs 5.65±1.36 d,两组间的差异具有统计学意义(P<0.05)。结论对于80 g以下的BPH,行膀胱造瘘术会增加手术时间、 膀胱冲洗时间、尿管留置时间及术后住院时间,降低了手术效率,对于双极TURP围手术期未见明显益处。
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关 键 词: | 前列腺增生 电切术 膀胱造瘘术 |
Value of suprapubic cystostomy in bipolar transurethral resection of the prostate for benign prostatic hyperplasia below 80 gram |
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Abstract: | Objective To investigate the perioperative benefit of suprapubic cystostomy in bipolar transurethral resection of the prostate (B-TURP) for treatment of benign prostatic hyperplasia (BPH) below 80 g. Methods This retrospective study was conducted in patients undergoing B-TURP for BPH below 80 g, who were stratified with respect of suprapubic cystostomy in B-TURP. The end points including the safety, efficiency, complications and nursing care were compared between the two groups. Results A total of 585 patients were enrolled, including 366 in cystostomy group and 219 in non-cystostomy group. The two groups showed similar postoperative reduction of serum sodium (0.06 vs 0.54 mmol/L, P>0.05), hematocrict (2.44% vs 2.89%, P>0.05), and blood hemoglobin concentration (9.62 vs 10.42 g/L, P>0.05), with comparable weight of resected prostate (42.50 vs 43.76 g, P>0.05). The operation time was significantly longer in cystostomy group than in non-cystostomy group (90.75 vs 76.28 min, P<0.05), but the rate of blood transfusion and incidences of postoperative fever and catheter blocking were comparable between the two groups. Compared with the non-cystostomy group, cystostomy group had significantly longer time for bladder washing (3.15 vs 2.57 days, P<0.05), catheter indwelling time (5.19 vs 4.15 days, P<0.05), and hospital stay after the operation (7.36 vs 5.65 days, P<0.05). Conclusions In B-TURP for BPH below the weight of 80 g, suprapubic cystostomy is associated with a longer time for operation, bladder washing, catheter indwelling and postoperative hospital stay, and thus provides no obvious benefits for the patients.
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Keywords: | benign prostatic hyperplasia electrotomy suprapubic cystostomy |
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