经尿道等离子前列腺电切术后常规24h橡皮筋牵拉气囊压迫止血效果观察

Clinical effect of elastics draw off balloon catheter for 24 hours on preventing bleeding after transurethral plasmakinetic resection of prostate

目的 观察经尿道等离子前列腺电切术（TUPKRP）后常规24 h橡皮筋牵拉气囊压迫法止血的临床效果.方法 我院2005年1月至2013年6月行TUPKRP治疗的700例良性前列腺增生症（BPH）患者,随机分为对照组298例和常规组402例,对照组术后经尿道膀胱内留置F22三腔气囊尿管,牵引固定于股内侧,牵引压迫前列腺创缘（面）2～3d,生理盐水持续膀胱冲洗;常规组术后经尿道膀胱内留置F22三腔气囊尿管,橡皮筋牵拉固定于足部,气囊压迫前列腺创缘24h,生理盐水持续冲洗膀胱.分别对两组术后出血天数（1、3、5 d）进行观察,血尿的转清例数、术后输血例数以及再次手术止血的病例数进行统计学分析.结果 对照组术后1、3、5d尿色未转清例数分别为52例、42例、24例.常规组未转清例数分别为34例、22例、10例,两组比较差异有统计学意义（x2值分别为6.608、9.279、7.624,P值分别为0.010、0.002、0.006）;对照组输血及再手术例数分别为15例和9例,常规组输血及再手术例数分别为6例和2例,两组比较差异有统计学意义（x2值分别为4.955、5.264,P值分别为0.026、0.022）.结论 常规24 h牵拉气囊压迫法能有效预防TUPKRP后出血,与对照组相比不但减少了出血,也缩短了气囊压迫时间,值得临床推广应用.

Objective To investigate the clinical effect of elastics drawing off balloon catheter for 24 hours on preventing bleeding after transurethral plasmakinetic resection of prostate （TUPKRP）.Methods Seven hundred patients with benign prostatic hyperplasia （BPH） underwent TUPKRP in the Eighth People＇s Hospital of Shanghai from Jan.2005 to Jun.2013 were randomly divided into control group （298 cases） and experiment group （402 cases）.Patients in control group after transurethral resection of the bladder were given treatment as follow：the bladder was placed with F22 cavity catheter,which were fixed on the medial femoral traction;prostate wound edge was pressed for 2-3 d and saline continuous irrigated bladder for avoiding infection.Patients in experiment group were given the same treatment with control group beside prostate wound pressed for 24 h.The days （1st,3rd,5th） of bleeding after operation,cases of hematuria turn clear,cases of postoperative blood transfusion and operation bleeding were recorded.Results Cases of hematuria disappeared postoperation at 1 st,3rd,5th days after operation were 52,42,24 cases in control group and 34,22,10 cases in experiment group.The differences were significant（x2 =6.608,9.279,7.624 ;P =0.010,0.002,0.006）.Cases of blood transfusion and reoperation in experiment group were 6 and 2 cases,lower than that in control group（15,9 cases ; x2 =4.955,5.264 ; P =0.026,0.022）.Conclusion The method of elastics drawing off balloon catheter for 24 hours improved the effect of preventing bleeding after TUPKRP.