围术期应用去氨加压素对经尿道前列腺电切术患者的影响

The effect of perioperative application of desmopressin on patients undergoing transurethral resection of prostate

目的观察围术期应用去氨加压素(DDAVP)对经尿道前列腺电切术(TURP)患者的影响。方法收集2018年1月-2019年3月湖北省黄冈市中心医院泌尿外科行TURP治疗的BPH患者124例,根据治疗方法不同分为治疗组70例和对照组54例。对照组给予常规对症治疗,治疗组在对照组的基础上应用DDAVP治疗。比较2组术前与术后2 h血红蛋白(Hb)、活化凝血活酶时间(APTT)、红细胞沉降率(ESR)及手术时间、膀胱冲洗液变清亮时间。术后1个月均接受随访,比较2组术前、术后1个月国际前列腺症状(IPSS)评分和生活质量(QOL)评分。结果术后2 h,2组Hb均低于术前,APTT长于术前,ESR高于术前,但治疗组变化幅度小于对照组(P <0.01)。治疗组手术时间及术后膀胱冲洗液变清亮时间均短于对照组(P <0.01)。术后1个月随访,2组IPSS、QOL评分均低于术前,且治疗组低于对照组(P <0.01)。结论围术期应用DDAVP能减少TURP患者术中、术后出血量,降低ESR,改善前列腺症状,提高患者生活质量。

Objective To observe the clinical efficacy of perioperative desmopressin(DDAVP) for transurethral resection of prostate(TURP).Methods 124 patients with BPH who underwent TURP treatment in the Department of Urology,Huanggang Central Hospital,Hubei Province from January 2018 to March 2019 were selected,according to different treatment methods,they were divided into the treatment group(70 cases) and the control group(54 cases).The control group was given conventional symptomatic treatment,and the treatment group was treated with DDAVP on the basis of the control group.The hemoglobin(Hb),activated thromboplastin time(APTT) and erythrocyte sedimentation rate(ESR) were compared between the two groups before and 2 hours after the operation,and the operation time and the time for the bladder irrigation fluid to become clear in the two groups were compared.All patients were followed up 1 month after operation,and the international prostate symptom score(IPSS) and quality of life(QOL) score were compared between the two groups before and 1 month after operation.Results At 2 hours after operation,the level of Hb in both groups were lower than before operation,APTT was longer than before operation,and ESR was higher than before operation,but the magnitude of change in the treatment group was smaller than that in the control group(P < 0.01).The operation time and the clearing time of bladder irrigation fluid in the treatment group were shorter than those in the control group(P < 0.01).After 1 month follow-up,the IPSS and QOL scores of the two groups were lower than those before the operation,and the treatment group was lower than the control group(P <0.01).Conclusion Perioperative DDAVP can reduce intraoperative and postoperative hemorrhage,reduce erythrocyte sedimentation rate,improve prostate symptomsand improve quality of life in TURP.