耻骨上前列腺切除术后常见并发症的预防分析

目的:探讨耻骨上前列腺切除术后常见出血、膀胱痉挛、膀胱颈挛缩、切口感染、尿失禁等并发症的原因及预防措施.方法:对114例前列腺增生患者术中采用深8字缝扎血管和可拆除荷包法缝合膀胱颈悬吊、对膀胱颈后唇抬高者行宽敞V形切除,避免损伤尿道外括约肌,术后置1根F22三腔导尿管并牵拉压迫、耻骨后间隙置1根血浆引流管、术后保留硬膜外导管并用自控镇痛泵持续给0.125%布比卡因(4ml/h).结果:采用上述治疗措施,疗效满意.术后常见并发症发生率明显降低(P＜0.05).结论:采用上述措施能有效防止上述5种常见并发症的发生.

Complications and prevention of subrapubic transvesical prostatectomy

Objective:To explore the etiology and prevention of common post-prostatectomy complications,including hemorrhage,wound infection,bladder detrusor muscle instability,incontinence and bladder neck contractures.Methods:The advanced prostatectomy techniques were performed on 114 BPH patients,including the deep 8-shaped suture of prostatic vessels,packet-shaped suture and slinging of bladder neck,a deep and wide V-shaped piece of tissue resected from the heightened posterior part of the bladder neck to avoid tear of the external urethral sphincter during operation period.A#22F three-way Foley urethral catheter for drainage and traction.A multiple hole rubber drain catheter was placed in retropubis,and was implanted 0.125% bupicarine was transfused into epidural continuously by patient controled epidural analgesia (PCEA) post-operatively.Results:Complication rate of patients treated with the above method decreased obviously( P <0.05).Conclusion:These data suggest that post-operation complications of BPH patients may be prevented.