经尿道前列腺等离子电切术术后失血量的危险因素分析

Analysis of risk factors affecting postoperative blood loss volume after transurethral plasmakinetic resection of prostate

目的分析影响经尿道前列腺等离子电切术(PKRP)术后失血量的危险因素。方法 80例行PKRP治疗的BHP患者,根据术后出血量分为观察组(冲洗液中含血量>30 mg/h,n=26)与对照组(冲洗液中血含量≤30 ml/h,n=54),比较两组年龄、术前基础性疾病、BPH病程、术后出血诱发原因等资料,分析影响PKRP患者术后出血量的影响因素。结果观察组与对照组糖尿病史、高血压史、贫血史、手术时间、术前服用抗血小板药物、术中损伤包膜、术中气囊导管安置不当、术中止血不彻底、术后膀胱痉挛、前列腺窝感染、术后便秘、活动过度等情况比较差异有统计学意义(P <0. 05);糖尿病史、术前服用抗血小板药物、术中损伤包膜、术中止血不彻底、术后膀胱痉挛均是影响PKRP术后出血的危险因素。结论术前积极控制患者基础性疾病,及时停用抗血小板药物,术后合理应用止痛药物,提高医者手术技巧,是降低PKRP患者术后出血风险的有效措施。

Objective To analyze the risk factors affecting postoperative blood loss volume after transurethral plasmakinetic resection of prostate(PKRP).Methods Eighty BHP patients treated with PKRP in our hospital were divided into observation group(blood volume in flushing fluid>30 mg/h,n=26)and control group(blood content in flushing fluid>30 ml/h,n=54)according to the postoperative blood loss volume.The data of age,preoperative basic diseases,BPH course and induced causes of postoperative blood loss were compared between the two groups,and the influencing factors affecting postoperative blood loss volume in the patients were analyzed.Results Univariate analysis showed that there were significant differences in history of diabetes,history of hypertension,history of anemia,operative time,preoperative use of antiplatelet drugs,intraoperative capsule injury,improper placement of intraoperative balloon catheter,incomplete intraoperative hemostasis,postoperative bladder spasm,prostatic fossa infection,postoperative constipation and hyperactivity between the two groups(P<0.05).Logistic multivariate regression analysis suggested that history of diabetes,preoperative use of antiplatelet drugs,intraoperative capsule injury,incomplete intraoperative hemostasis and postoperative bladder spasm were risk factors for postoperative blood loss after PKRP.Conclusion Preoperative active control of underlying diseases,timely discontinuation of antiplatelet drugs,postoperative rational application of analgesics and improvement of surgical techniques of doctors are effective measures to reduce the risk of postoperative blood loss in patients with PKRP.