经尿道电凝止血在开放性前列腺切除术中的应用价值

Clinical research about means of hemostasis in prostatectomy

目的探讨耻骨上经膀胱前列腺切除术中有效的止血方法。方法2001年8月至2006年4月我院对62例良性前列腺增生患者施行耻骨上经膀胱前列腺切除术,其中32例采用传统手术方法并配合经尿道电凝止血,30例采用单纯传统手术方法止血。结果两组手术时间(82±19minvs79±22min,t=0.297,p=0.589)、术中出血量(200±78mlvs192±73ml,t=0.415,p=0.497)、术中输血例数(7/32vs8/30,x2=0.025,p=0.879)无显著性差异;配合经尿道电凝止血组术后冲洗液转清时间(1±0.5dvs4±1d,t=-19.723,p=0.000)、术后留置尿管时间(10±7dvs19±8d,t=-5.389,p=0.000)、术后出现膀胱痉挛机会(3/32vs15/30,x2=8.010,p=0.003)、术后下床活动时间(4±2dvs19±9d,t=-8.726,P=0.000)及术后住院时间(16±5dvs29±12d,t=-3.817,p=0.000)均优于单纯传统方法止血组。结论耻骨上经膀胱前列腺切除术中配合采用经尿道电凝止血可有效减少术后出血,术后恢复快,是一种较好的改良术式。

Objective To explore an effective means of hemostasis in prostatectomy. Methods A total of 62 cases of benign prostatic hyperplasia were surgically treated in this hospital from August 2001 to April 2006, including 32 cases of suprapubic prostatectomy combined with hemostasis by the ureter way （Combination Group） and 30 cases of simpal suprapubic prostatectomy （Simpal Group）. Results There were no significant differences in the operation time （82±19 min vs 79±22min, t=0.297, p=0.589）, blood loss （200±78ml vs 192±73ml, t=0.415, p=0.497） and blood transfusion rate （7/32 vs 8/30, X^2=0.025, p=0.879）during the operation between the two groups. The Combination Group was superior to the Simpal Group in the time to bladder perfusion clearance（l±0.5d vs 4±ld, t=-19.723, p=0.000）,the postoperative catheterization time（10±7d vs 19±8d, t=-5.389, p= 0.000）, the chance of bladder spasm （3/32 vs 15/30, X^2=8.010, p=0.003）, the time to get out of bed （4±2d vs 19±9d, t=-8.726, p=0.000）, and the postoperative hospital stay （16±5d vs 29±12d, t=-3.817, p=0.000）. Conclusions Prostatectomy. Combined with hemostasis by the ureter way is a safe and effective means of hemostasis.