不同灌注液压力在尿道前列腺电切术中的效果比较

Comparison of the effect of different perfusion fluid pressure in transurethral resection of the prostate

目的探究不同灌注液压力对行经尿道前列腺电切术(TURP)治疗的前列腺增生(BPH)患者康复效果的影响。方法选取2017年7月至2018年8月安徽省蚌埠市第三人民医院收治的60例行TURP术治疗的BPH患者,按照随机数字表法分为观察组和对照组,每组各30例。对照组术中采用60 cm(灌注液最下缘至膀胱的垂直距离)高度灌洗,观察组采用40 cm高度灌洗,比较两组患者的手术相关临床参数[平均动脉压(MAP)、心率(HR)、血红蛋白(Hb)、血细胞比容(HCT)、血钠(Na^(+))]、膀胱冲洗时间、留置尿管时间、术后住院时间、手术时间、最大尿流率(Q_(max))、国际前列腺症状评分(IPSS)、生活质量(QOL)评分及并发症情况。结果术中60 min时,两组患者的HR、MAP均较术前升高,且对照组的HR、MAP均高于观察组,差异均有统计学意义(均P<0.05);观察组手术前后的Hb、HCT、Na^(+)下降值低于对照组,差异均有统计学意义(均P<0.001);观察组的膀胱冲洗时间、留置尿管时间、术后住院时间低于对照组,差异均有统计学意义(均P<0.05);相比于术前,术后3个月两组的Q_(max)均明显升高,IPSS评分、QOL评分均明显下降,差异均有统计学意义(均P<0.05),两组患者术后3个月的Q_(max)、IPSS评分、QOL评分比较,差异均无统计学意义(均P>0.05);观察组的术后出血率及总并发症发生率低于对照组,差异均有统计学意义(均P<0.05)。结论BPH患者行TURP过程中适当降低灌注液压力可缩短术后膀胱冲洗、留置尿管及住院时间,减少术后出血的发生,促进患者康复。

Objective To explore the effect of different perfusion pressures on the rehabilitation in patients with benign prostatic hyperplasia(BPH)undergoing transurethral resection of the prostate(TURP).Methods Sixty patients with BPH treated by TURP in our hospital from July 2017 to August 2018 were enrolled and divided into observation group and control group according to the random number table method with 30 cases in each group.The control group received lavage at a height of 60 cm(vertical distance from the lowest edge of perfusion solution to bladder),and the observation group received lavage at a height of 40 cm.The clinical parameters(MAP,HR,Hb,HCT,Na^(+)),bladder irrigation time,indwelling catheter time,postoperative hospitalization time,operation time,and _(max)imum urine flow rate(Q_(max)),international prostate symptom score(IPSS),quality of life(QOL)score and complications were compared.Results At 60 minutes,HR and MAP in both groups were higher than those before surgery,but the change was more obvious in the control group,and the differences were statistically significant(all P<0.05).The decrease of Hb,HCT and Na^(+)in the control group before and after operation in the observation group was lower than that in the control group,and the differences were statistically significant(all P<0.001).The duration of bladder irrigation,indwelling catheter and postoperative hospitalization in the observation group were all lower than those in the control group,and the differences were statistically significant(all P<0.05).Compared with preoperation,Q_(max) was significantly increased in both groups 3 months after operation,while IPSS score and QOL score were significantly decreased,and the differences were statistically significant(all P<0.05),and there were no significant differences in Q_(max),IPSS score and QOL score between the two groups 3 months after surgery(all P>0.05).The postoperative bleeding rate and total complications in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).Conclusions Properly perfusion pressure reduction in patients with benign prostatic hyperplasia under TURP can shorten time of postoperative bladder irrigation,indwelling catheter and postoperative hospitalization,reduce the incidence of postoperative bleeding,and promote patients'recovery.