多种干预措施对前列腺电切术后膀胱痉挛的影响

Effect of multiple treatments on cystospasm after transurethral resection of prostate

目的探讨多种干预措施对前列腺电切术后患者膀胱痉挛发生率及严重程度的影响。方法回顾性分析2006年至2013年于我科行前列腺增生电切术后的663例患者资料,根据研究因素将患者分为6组:2组分别为使用硅胶导尿管或乳胶导尿管,作为导尿管观察组;2组分别使用加温冲洗液或常温冲洗液,作为冲洗液温度观察组;2组分别使用丁卡因混合冲洗液或普通冲洗液,作为混合冲洗液观察组。观察2种处理措施对各组患者膀胱痉挛的发生率、持续时间及疼痛视觉模拟评分的影响,并进行统计学比较。结果使用硅胶导尿管、加温冲洗液、丁卡因混合冲洗液的各观察组患者组术后膀胱痉挛的发生率、持续时间及疼痛视觉模拟评分明显低于对照组。其机制可能与硅胶导尿管及加温冲洗液减少了对膀胱黏膜的刺激,丁卡因胶浆能有效降低膀胱神经敏感性有关。结论使用硅胶导尿管、加温冲洗液及丁卡因混合冲洗液处理,可以明显降低前列腺电切术后患者膀胱痉挛的发生率及症状的严重程度。

Objective To investigate the effect of multiple treatments on cystospasm after transurethral resection of prostate（ TURP）.Methods From 2006 to 2013,663 patients who had received TURP for BPH were civided into 6 groups： 2 were treated by kieselgel or lactoprene urethral catheter,defined as catheter observe group. 2 were treated by warmed or ordinary temperature douche,defined as temperature observe group. 2 were treated by dicaine mixed or normal douche,defined as mixed douche observe group. The incidence rates and duration of cystospasm and visual analogue scores of pain were observed and the diversities were measured by statistics within each pair groups. Results The incidence rates and duration of cystospasm and visual analogue scores of pain of groups treated by kieselgel urethral catheter,warmed douche and dicaine mixed douche were obviously lower than the groups treated by lactoprene urethral catheter,ordinary temperature douche and normal douche. The kieselgel urethral catheter and warmed douche decreasing the irritation on mucous membrane of bladder,the dicaine decreasing the sensibility of bladder nerves may be the mechanism. Conclusion The incidence rates and duration of cystospasm and visual analogue scores of pain can be obviously decreased by treatments of kieselgel urethral catheter,warmed douche and dicaine mixed douche.