经尿道前列腺电切术后膀胱冲洗液温度对膀胱痉挛的影响

Influence of the Bladder Irrigation Fluid Temperature to Bladder Spasm after Transurethral Resection of Prostate (TURP)

目的:(1)了解经尿道前列腺电切术后患者不同温度冲洗液冲洗膀胱时发生膀胱痉挛的频率、持续时间及强度。(2)通过对经尿道前列腺电切术后不同温度冲洗液冲洗膀胱时红细胞计数的观察,研究加温盐水冲洗膀胱是否会加重伤口出血。方法:将70例因前列腺增生症行前列腺电切术后持续膀胱冲洗的患者采用便利抽样的方法分为两组,分别使用加温盐水冲洗液(35±2)℃和常温盐水冲洗液(20±2)℃进行术后持续膀胱冲洗,记录两组患者膀胱痉挛发生次数、持续时间及程度、术后每天冲洗液红细胞数进行临床观察。结果:(1)加温盐水冲洗膀胱能缓解患者的膀胱痉挛症状。(2)加温盐水冲洗膀胱冲洗液红细胞计数明显低于常温盐水。加温盐水能更有效地减少出血量。结论:TURP术后用(35±2)℃盐水进行膀胱冲洗,对膀胱刺激小,减少了膀胱痉挛次数,缩短痉挛持续时间,减轻痉挛疼痛,使血管保持正常的舒缩功能,从而有效减少术后出血,预防了并发症的发生,是一种安全、简便、有效的方法。对冲洗液适度加温在临床护理中可以推广应用。

Objective：This study was designed to evaluate the frequency, intensity and duration of bladder spasm of patients irrigated by different temperatures fluid after transurethral resection of prostate （TURP）.Meanwhile,we elucidated whether bladder flush with warm saline solution increased wound bleeding,through investigating red cell count of flush fluid of different temperature after TURP.Methods：Seventy patients with BPH after TURP were randomly divided into two groups （A and B） （n=35,respectively）,and temperature range of irrigation fluid were （22±24）℃ （the room temperature） and （33-37）℃ in two groups respectively.The frequency, intensity and duration of bladder spasm were observed,and the amount of red cell from daily rinse was measured in both A and B groups.Results：Less bladder spasm symptom was found in group B,compared with group A （P〈0.05）.The amount of red cell was significantly lower in group B than in group A （P〈0.05）,suggesting that the heated saline solution can effectively reduce the amount of bleeding.Conclusion：The irrigation fluid temperature ranged from 33℃ to 37℃ may be the best choice for BPH patients after TURP.It is a safe,simple and effective method to reduce the postoperative bleeding and prevent the occurrence of complications via decreasing the frequency, intensity and duration of bladder spasm and maintaining normal systolic and diastolic function of blood vessels.