经尿道前列腺电切术后低浓度过氧化氢溶液膀胱冲洗的疗效分析

Low-concentration hydrogen peroxide solution for continuous bladder irrigation after transurethral resection of the prostate

目的:评价低浓度过氧化氢溶液在经尿道前列腺电切术(TURP)后持续膀胱冲洗中有效性和安全性。方法:回顾性分析2013年1月至2017年1月期间共148例良性前列腺增生(BPH)行TURP手术治疗的患者临床资料。根据患者术后持续膀胱冲洗液的不同分为A、B两组,A组76例接受0.15%过氧化氢溶液行膀胱冲洗;B组72例接受生理盐水行膀胱冲洗。记录两组患者术后血红蛋白浓度值下降情况,膀胱持续冲洗时间,导尿管堵塞次数、留置导尿管时间,术后住院天数。结果:术前两组患者前列腺体积、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿(PVR)、PSA及血红蛋白值相比差异无统计学意义(P>0.05)。术后48 h内平均血红蛋白(Hb)下降水平:A组Hb下降了(3.38±2.56)g/L,B组Hb下降了(7.29±6.58)g/L;持续膀胱冲洗时间:A组为(32.57±5.99)h,B组为(46.10±8.79)h;两组相比差异均有统计学意义(P<0.01)。A组患者术后尿管堵塞率为3.3%、留置尿管时间为(3.74±0.79)d、住院天数为(4.22±0.81)d;B组术后尿管堵塞率为11.8%、留置尿管时间为(4.79±0.93)d、住院天数为(4.67±0.88)d;两组相比差异均有统计学意义(P<0.01)。结论:前列腺电切术后应用低浓度过氧化氢溶液行膀胱持续冲洗可以减少出血,降低导尿管堵塞发生率,缩短膀胱冲洗时间、术后导尿管留置时间和住院天数,值得在临床中进行推广。

Objective： To evaluate the effectiveness and safety of low-concentration hydrogen peroxide solution （HPS） for con- tinuous bladder irrigation after transurethral resection of the prostate （TURP）. Methods ： We retrospectively analyzed the clinical da- ta about 148 cases of benign prostatic hyperplasia （BPH） treated by TURP from January 2013 to January 2016. Seventy-six of the pa- tients received postoperative continuous bladder irrigation with 0.15% HPS （group A） and the other 72 with normal saline （group B）. We compared the two groups of patients in their postoperative hemoglobin （Fib） levels, duration of bladder irrigation, frequency of catheter blockage, time of catheterization, and length of hospital stay. Results： There were no statistically significant differences between the two groups of patiems preoperatively in the prostate volume, International Prostate Symptoms Score, maximum urinary flow rate, postvoid residual urine, or levels of serum PSA and Fib （P 〉 0.05）. At 48 hours after operation, a significantly less reduction was observed in the Hb level in group A than in group B （[3.38±2.56] vs [7.29 ±6.58] g/L, P 〈 0.01）. The patients of group A, in comparison with those of group B, also showed remarkably shorter duration of postoperative bladder irrigation （ [32.57 ± 5.99] vs [46. 10 ± 8.79] h, P 〈 0.01）, lower rate of catheter blockage （3.3% vs 11.8%, P 〈 O. 01 ）, shorter time of catheterization （ [ 3.74 ± 0.79] vs [4. 79±O. 93 ] d, P 〈 0.01）, and fewer days of postoperative hospital stay （[4.22± 0.81] vs [4.67± 0.88] d, P 〈 0.01）. Conclusion： Low-concentration HIX3 for continuous bladder irrigation after TURP can reduce blood loss, catheter blockage, bladder irrigation duration, catheterization time, and hospital stay, and therefore deserves a wide clinical application.