输尿管置管尿液转流不隔离腺窝前列腺切除术(附30例报告)

Prostatectomy through Urinary Diversion by Indwelling Ureteral Cathet er without Dissection of Gland Fossa (A Report of 30 Cases)

目的 探讨减少前列腺切除术中出血 ,预防术后膀胱痉挛及膀胱出口梗阻的有效方法。方法 对 30例前列腺增生症 (BPH)患者行输尿管置管尿液转流不隔离腺窝前列腺切除术 ,对 15例对照组BPH病人采用传统耻骨上前列腺切除术治疗。记录术中、术后失血量 ,对术后膀胱痉挛进行症状评分 ,比较手术前后尿道造影情况及尿流率等指标。 结果 研究组术后出血平均 180 .0ml;与对照组2 87.7ml相比 ,有非常显著差异 (P <0 .0 1) ;研究组膀胱痉挛症状评分平均 2 .4分 ;与对照组 3.5分相比 ,差异显著 (P <0 .0 5 )。研究组术中出血平均 130ml,术后均排尿通畅 ,排尿期膀胱尿道造影示前列腺段尿道较术前平均增粗 0 .5cm ;最大尿流率平均 2 2 .5ml/s,与对照组相比均无显著差异。结论 输尿管置管尿液转流不隔离腺窝前列腺切除术是减少出血。

Objective To implore the effective method to d ecrease blood loss, prevent postoperative bladder spasm and bladder outlet obstr uction in prostatectomy. Methods 30 patients with prosta tic hyperplasia (Study Group) underwent prostatectomy through urinary diversion by indwelling ureteral catheter without dissection of gland fossa. 15 patients u nderwent classical prostatectomy (Control Group). Intra- and postoperative bloo d loss, bladder spasm scoring, peri- and postoperative urethrography and urine flow rate of two group were analyzed. Result Significant difference was found on postoperative blood loss and bladder spasm scoring betw een study group and control group. Intraoperative blood loss, mean maximun flow rates showed no significant difference between two groups. Conclusio ns Prostatectomy through urinary diversion by indwelling ureteral ca theter without dissection of gland fossa is an effective method to reduce blood loss, prevent bladder spasm and bladder outlet obstruction.