经尿道前列腺电切术后低血压相关因素分析

Analysis of factors related to hypotension after transurethral resection of the prostate

目的通过分析经尿道前列腺电切(TURP)术后低血压的相关危险因素,探讨TURP术后低血压的预防对策。方法对重庆永荣矿业公司总医院61例TURP术后发生低血压患者与86例未发生低血压患者的年龄、手术总时间、前列腺切除重量、包膜切穿后手术时间、失血量、术后血钠浓度、术后体温采用logistic回归分析。结果统计结果显示,包膜切穿后手术时间长、失血量大、术后血钠浓度低、术后体温低是术后低血压的危险因素,而患者年龄、手术总时间、前列腺切除重量与术后低血压不相关。结论 TURP术中应采取各种措施避免切穿前列腺包膜、减少水吸收、减少失血量,提高手术技巧、膀胱造瘘术、加热膀胱冲洗液能够有效预防术后低血压。

Objective To analyze the factors related to hypotension after transurethral resection of the prostate（TURP） and explore the prevention strategies. Methods Clinical data were collected from61 patients with postoperative hypotension and 86 patients without postoperative hypotension after transurethral resection of the prostate in General Hospital of Yongrong Mining Corporation Limited Hospital, Third Military Medical University. Patients＇ age, total operation time, prostate resection weight,operation time after capsule perforation, blood less, postoperative sodium level, and postoperative body temperature were analyzed with logistic regression. Results Long operation time after capsule perforation,massive hemorrhage, low postoperative sodium level, and low postoperative body temperature were dangerous factors of postoperative hypotension, while patients＇ age, operation time, and prostate resection weight were not related to postoperative hypotension. Conclusion We must take some measures to avoid capsule perforation, reduce water absorption and reduce hemorrhage in the process of TURP. Improvement of operation skills, cystostomy and heating bladder irrigating fluid can efficiently prevent hypotension after TURP.