经尿道前列腺等离子电切围术期停用抗凝药物的安全性分析及血浆钙浓度变化

Safety analysis of withdrawal of anticoagulants during perioperative period of transurethral plasma kinetic prostatectomy and changes of plasma calcium concentration

目的分析经尿道前列腺等离子电切(TUPKP)围术期停用抗凝药物的安全性。方法回顾性分析梧州市红十字会医院泌尿外科2015年1月至2019年12月收治的前列腺增生并行TUPKP患者46例,按术前是否口服抗凝药分组,其中23例口服抗凝药物为A组,23例术前未口服抗凝药物者为B组。比较两组的血钙值、血红蛋白(HGB)、血钠值、手术时间、术中出血量、膀胱冲洗液用量及手术时间、术后并发症等临床资料。结果两组患者手术均顺利完成,无心脑血管事件发生,术中出血量,术中、术后HGB值、血钙值、膀胱冲洗液用量及手术时间,术后并发症等比较,差异均无统计学意义(P>0.05)。结论术前7 d停用抗凝药物后行TUPKP,不增加手术出血风险,不增加心脑血管疾病发生率,是安全、有效的;围术期重视血钙浓度变化并维持平衡。

Objective To analyze the safety of the withdrawal of anticoagulants during perioperative period of transurethral plasma kinetic prostatectomy(TUPKP).Methods The clinical data of 46 patients with benign prostatic hyperplasia underwent TUPKP admitted to the Department of Urology,Wuzhou Red Cross Hospital from January 2015 to December 2019 were analyzed retrospectively.According to whether oral anticoagulants were taken before operation,23 cases were assigned into group A(with oral anticoagulants)and 23 cases were assigned into group B(without oral anticoagulants).The blood calcium value,hemoglobin(HGB),blood sodium value,operation time,blood loss,dosage and time of bladder irrigation fluid,postoperative complications were compared between the two groups.Results The operation was successfully completed in both groups,and no cardiovascular and cerebrovascular events occurred.There were no significant differences in intraoperative blood loss,intraoperative and postoperative HGB values,blood calcium values,dosage and time of bladder irrigation fluid,and postoperative complications(P>0.05).Conclusion TUPKP performed after the withdrawal of anticoagulants7 days before operation does not increase the risk of surgical bleeding and the incidence of cardiovascular and cerebrovascular diseases,which is safe and effective.Attention should be paid to the change of blood calcium concentration and maintain its balance during perioperative period.