术后硬膜外镇痛结合围手术期心理支持疗法对减少前列腺摘除术后出血的疗效观察

Effect of patient-controlled epidural analgesia and perioperative psychological support therapy on bleeding in patient undergoing prostatectomy

目的:观测比较术后硬膜外镇痛(PECA)结合围手术期心理支持疗法(PPST)对减少前列腺摘除术后前列腺窝出血的临床效果。方法:选取耻骨上经膀胱前列腺摘除术患者45例,随机分成两组:Ⅰ组25例,由专人按标准程序做PPST,并于给予PECA;Ⅱ组20例,给予常规术后镇痛。术后以VSA评分观察镇痛效果,对比膀胱出血量、膀胱冲洗时间、用液量及膀胱痉挛次数和持续时间。结果:Ⅰ组膀胱冲洗时间、用液量均较Ⅱ组减少(P<0.05);膀胱痉挛次数和持续时间、膀胱出血量两者比较差异有统计学意义(P<0.01)。结论:PPST结合PECA能减少前列腺术后出血,其疗效确切、安全,有利于术后恢复。

Objective：To compare the efficacy of patient-controlled epidural analgesia（PCEA） and perioperative psychological support therapy（.PPST） on treatment of bleeding in patients prostate fossa after prostatectomy. Methods：Forty cases of patients undergoing suprapublic prostatectomy were divided into two groups randomly, group Ⅰ of 25 cases received patient controlled epidural analgesia（PCEA） and perioperative psychological supportive therapy（PPST） ,and groupⅡ of 20 cases received routine postoperative analgesia. The effects were evaluated by VSA score, the quantity of bleeding, lasting hours, liquid quantity of rinse bladder, the times of bladder spasna and duration. Results： Group Ⅰ was noted superior to group Ⅱ with the lasting hours and liquid quantity of rinse bladder（ P 〈0.05） ; The differences in the times of bladder spasna,duration and quantity of bleeding were of very significant （ P 〈0.01）. Conclusions： PPST and PECA could shorten bleeding time after pro statectomy. Its efficacy is certain, has merits of safe and rapid rehabilitation.