三腔双囊管在前列腺手术中的应用

目的:探讨巨大前列腺增生症开放手术应用三腔双囊导尿管及术后硬膜外镇痛与并发症减少的关系。方法:本组84例病人,均为开放性手术,术中应用三腔双囊导尿管,术后分两组分别应用硬膜外镇痛或静脉镇痛。术中放置膀胱造瘘管一根,术后第5天予拔除。术后第7天间断拆线出院。结果:全部84例病人术后导尿管尿液清晰,无出血。20例病人术后12~24 h内有可耐受的肛门内坠胀感,硬膜外镇痛组病人膀胱痉挛2例,切口感染2例,无尿漏及谵妄。静脉镇痛组病人膀胱痉挛6例,切口感染4例,谵妄4例,尿漏1例,全部84例病人中尿失禁3例,随访1月后正常,除6例Ⅱ期愈合外,其余切口均Ⅰ期愈合出院。随访至今病人自觉良好。结论:前列腺增生开放手术应用三腔双囊导尿管及硬膜外镇痛具有并发症少,恢复快的优点,是巨大前列腺增生症或前列腺增生合并膀胱憩室、结石等行开放手术时一种较好选择。

Application of Sengstaken-Blakemore tube to benign prostate hyperplasia surgery

Objective:To determine whether the application of Sengstaken-Blakemore tube in open prostatectomy to large benign prostatic hyperplasia combined with postoperative epidural analgesia would be associated with decreased complications.Methods: 84 cases of benign prostate hyperplasia were treated with open prostatectomy.Sergstaken-Blakemore tube had been applied in 84 patients during the operation and remained unobstructed after surgery combined with postoperative epidural analgesia or narcotics given intravenously.A fistula tube of urinary bladder had been placed in each patient and was removed in 5 days,and stitches were removed intermittedly in 7 days.Results:The urine in urinary catheters of all the patients was clear with no sign of bleeding.There was a tolerant feeling of falling and expanding inside anus 12～24 hours after surgery in 20 patients.In patients with postoperative epidural analgesia,2 suffered from cystospasm,2 from wound infection but no seeping urine or postoperative delirium occurred.In patients with intravenous analgesia,6 suffered from cystospasm and another 6,postoperative delirium;1 from seeping urine and another 4,wound infection.All patients were discharged with the first period healing apart from 3 with incontinence and 6 with the second period healing.The follow-up suggested that all the patients got a good recovery.Conclusion: The application of Sengstaken-Blakemore tube in open prostatectomy combined with postoperative epidural analgesia can be sound for its less complications and quicker recovery in treating large benign prostate hyperplasia or benign prostate hyperplasia combined with diverticulum of bladder or calculi.