前列腺增生并急性尿潴留急诊导尿失败后两种治疗方法比较

Analysis of Percutaneous Cystotomy and Urethral Catheterization with Ureteroscope in the Treatment of Acute Urinary Retention

目的：对比前列腺增生并急性尿潴留急诊导尿失败后耻骨上膀胱穿刺造瘘和输尿管镜辅助下留置尿管两种治疗方法的临床疗效。方法：对50例老年前列腺增生并急性尿潴留急诊导尿失败的患者，随机均分两组，一组采用传统的耻骨上膀胱穿刺造瘘（膀胱穿刺造瘘组），另一组采用在输尿管镜辅助下留置导尿管（输尿管镜导尿组），比较两组手术时间，手术并发症发生率，术后疼痛视觉模拟评分（VAS），膀胱刺激征，尿路感染率等指标。结果：膀胱穿刺造瘘组在手术时间上要短于输尿管镜导尿组，两组比较有显著差异（P〈0．05）；但输尿管镜导尿组在手术并发症发生率和术后疼痛VAS评分方面要少于膀胱穿刺造瘘组，两组比较有显著差异（P〈0．05）；膀胱刺激征和尿路感染率，在短期内（7d）两组比较差异不明显（P〉0．05）。结论：输尿管镜辅助下留置导尿管虽然在手术时间上稍长，但操作简单安全，患者痛苦小，手术并发症少，较传统耻骨上膀胱穿刺造瘘术的临床疗效好。

OBJECTIVE ： To compare the clinical effects of percutaneous cystotomy and urethral catheterization with ureteroscope in treatment of prostatic hyperplasia patients with acute urinary retention. METHODS ： 50 Prostatic hyperplasia patients with acute urinary retention after routine urethral catheterization failure were randomly divided into two groups. 25 patients underwent conventional percutaneous suprapubie eystostomy （eystostomy group） and 25 patients underwent urethral catheterization with ureteroseope （catheterization group）. Operative time, operative complication and visual analogue scale （VAS） were compared between the two groups. RESULTS ： The operations of 50 cases were successfully performed. In eystostomy group, operative time was shorter than that in catheterization group （ P 〈 0. 05 ）. Operative complication and pain score in catheterization group were lower than those in cystostomy group （ P 〈 0. 05 ）. There were no significant differences in vesieal irritability and the incidence of urinary tract infection in the two groups （ P 〈 0. 05 ）. CONCLUSION ： Urethral catheterization with ureteroseope is a simple and safe procedure and the clinical effect is better than conventional percutaneous cystotomy.