导致前列腺术后膀胱痉挛的相关因素分析及预防对策探讨

Analysis of Related Factors Leading to Bladder Spasm after Prostate Operation and Prevention Measures

目的观察引起前列腺术后膀胱痉挛的危险因素,探讨相应预防措施。方法选择2012年1月—2018年12月该院符合良性前列腺增生的诊断标准在硬膜外麻醉下实施经尿道前列腺电切术患者190例作为观察研究对象,对术后膀胱痉挛发生情况进行统计,比较发生膀胱痉挛(观察组)及未发生膀胱痉挛者(对照组)两组患者在年龄、文化程度、精神因素、术前感染、术后出血、尿管刺激、腹压增高、膀胱冲洗不当等方面上差异。结果 190患者发生膀胱痉挛70例,发生率36.84%(70/190),临床表现患者在术后存在明显的排尿急感、膀胱充盈肿胀感以及疼痛感等。观察组存在精神因素68.57%、术前感染24.29%、术后出血14.29%、尿管刺激34.29%、腹压增高25.71%、冲洗液温度不当28.57%高于对照组的25.00%、8.33%、5.00%、13.33%、11.67%、10.00%(χ^2=16.33、6.25、4.11、4.86、5.23、6.74,P<0.05),上述是导致膀胱痉挛的相关因素,年龄≥70岁62.86%vs 58.33%;中学以上文化14.29%vs 20.00%差异无统计学意义(χ^2=0.89、2.04,P>0.05)。结论导致前列腺术后发生膀胱痉挛因素复杂,应针对上述因素进行预防,降低术后发生膀胱痉挛的发生。

Objective To observe the risk factors of bladder spasm after prostate surgery and explore the corresponding preventive measures. Methods From January 2012 to December 2018, this hospital met the diagnostic criteria for benign prostatic hyperplasia. Under the epidural anesthesia, 190 patients underwent transurethral resection of the prostate were used as observational subjects to analyze the incidence of postoperative bladder spasm. Compared with patients with bladder spasm (observation group) and those without bladder spasm (control group), age, education level, mental factors, preoperative infection, postoperative bleeding, urinary tract irritation, increased abdominal pressure, improper bladder irrigation differences in other aspects. Results There were 70 cases of bladder spasm in 190 patients, the incidence rate was 36.84%(70/190). The clinical manifestations showed obvious urinary urgency, bladder filling and swelling and pain. In the observation group, there were 68.57% of mental factors, 24.29% of preoperative infection, 14.29% of postoperative bleeding, 34.29% of urinary tract stimulation, 25.71% of abdominal pressure, and 28.5% of improper irrigating temperature, which was higher than 25.00%, 8.33%, 5.00%, 13.33%, 11.67%, 10.00% of the control group (χ^2 =16.33, 6.25, 4.11, 4.86, 5.23, 6.74, P<0.05);which was a related factor leading to bladder spasm, age ≥70 years old 62.86% vs 58.33%;above secondary school culture 14.29% vs 20.00%, and difference were statistically significant (χ^2 =0.89, 2.04, P>0.05). Conclusion The factors leading to bladder spasm after prostate surgery are complicated. The above factors should be prevented to reduce the occurrence of postoperative bladder spasm.