经尿道前列腺电切术后不同时间拔除导尿管的安全性研究

Safety of catheter removal at different times after transurethral resection of prostate

目的 探讨前列腺增生患者行经尿道前列腺电切术后不同时间拔除导尿管的临床疗效及安全性.方法 回顾性分析2018年1月至2020年1月由河南大学淮河医院及信阳市中心医院收治的行经尿道前列腺电切术治疗的600例前列腺增生患者的临床资料,按照术后留置导尿管时间的长短分为对照组和观察组,每组300例.对照组术后留置导尿管7 d,观察组术后留置导尿管3 d,比较两组患者拔除导尿管后的排尿情况、术后6周复查时的尿道功能、术后国际前列腺症状评分(IPSS)、生活质量(QOL)评分及并发症发生率.结果 两组患者拔除导尿管后的排尿情况、术后6周随访时的尿道功能、IPSS评分、QOL评分及相关并发症(下尿路症状、尿道狭窄、尿失禁、血尿)的发生率比较,差异均无统计学意义(均P>0.05).术后6周患者复查时,两组患者的Q_(max)均显著提高,RUV明显下降,与术前比较,差异均有统计学意义(均P<0.05).观察组患者的尿路感染发生率明显低于对照组,差异有统计学意义(P<0.05).结论 经尿道前列腺电切术后3 d与7 d拔除导尿管都是安全可行的,但3 d拔除导尿管可使患者尿路感染的发生率更低,且未增加其他并发症的发生率,值得在临床上推广.

Objective To investigate the efficacy and safety of removing the catheter at different time after tranurethral resection of prostate in patients with prostatic hyperplasia.Methods A retrospective analysis was performed on 600 patients with prostatic hyperplasia who underwent tranurethral resection of the prostate from January 2018 to January 2020 in Huaihe hospital of Henan university and Xinyang central hospital.According to the duration of indwelling catheter,the patients were divided into two groups with 300 patients in each group.The catheter was indwelled for 7 days in the control group and 3 days in the observation group.The urination after catheter removal,urethral function at 6 weeks after surgery,postoperative IPSS score,QOL score and complication rate were compared between the two groups.Results There was no statistical significance in urination after urethral catheter removal,urethral function,IPSS score,QOL score and incidence of related complications(lower urinary tract symptoms,urethral stricture,urinary incontinence and hematuria)between two groups(all P>0.05).At the time of reexamination 6 weeks after operation,Q_(max) of the two groups was significantly increased,and RUV was significantly decreased,and the differences were statistically significant compared with those before operation(all P<0.05).At 6 weeks after operation,Q_(max) was significantly increased and RUV was significantly decreased in both groups,with statistically significant differences compared with those before operation(all P<0.05).However,the incidence of urinary tract infection in observation group was significantly lower than that in control group,with statistical significance(P<0.05).Conclusions It is safe and feasible to remove the urethral catheter 3 days and 7 days after tranurethral resection of the prostate,but the urethral catheter 3 days can lower the incidence of urinary tract infection and does not increase the incidence of other complications,so it is worthy of clinical promotion.