冲洗液温度对前列腺切除术后出血的影响

Influence of irrigating fluid temperature on post prostatectomy bleeding

目的 研究冲洗液温度对前列腺切除术后出血的影响。方法 耻骨上前列腺切除术患者80例,年龄60～82(平均67.4±10.3)岁,随机分为两组各40例。A组采用20℃的冲洗液冲洗膀胱,B组采用37℃的冲洗膀胱。两组所有患者均于膀胱冲洗前抽静脉血,分别测定其在20℃和37℃状态下的激活部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)。同时比较两组术后出血量、冲洗总液量、血尿时间、寒冷反应及膀胱痉挛发生率,结果 检测80例患者血APTT,PT,TT均存在显著差异(P<0.001;冲洗总液量分别是(47883±±8953)ml和(19741±5490)mL,P<0.001;尿液转清时间分别是(47.5±16.9)h和(19.8±5.7)h,P<O.001;膀胱痉挛者发生比例是24/40和11/40(P<0.01);寒冷反应者发生比例是13/40和2/40(P<0.01)。结论 采用37℃的冲洗液冲洗膀胱,是防止前列腺切除术后出血的有效方法。

ALM To investigate the influence of urigating fluid temperature on bleeding of postprostatectomy. METHODS 80 cases of suprapubic prostatectomy(age ranging from, 60 to 82 years,meam67.4±10.3)were randomizely divided into two groups,the 20℃ irrigation fluid (Group A,40 patients)and 37℃ irrigating fluid group (Group B,40 patients). Blood samples of all patients were obtaining for the mea-surements of the activated partial thromboplastin time(APTT), plasma prothrombin time (PT)and thrombin time(TT) at 20℃ and 37℃ , re-spectively. The bleeding volume, total irrigating fluid volume, hematuria time and incidence of frigidity and cystospasm in two groups were compared simultaneously.RESULTS In all patients,APIT,PT and TT at 20℃ were prolonged significantly as compared with those at 37℃ ( P < 0.001),The bleeding volume and total irrigating fluid volume in two groups were significantly different (103±36 mL vs40±15 mL, and 47883 ±8953 mL vs 19741±5490 mL,P< 0.001).The hematuria time in group A was longer than that in group B (47.5 ±16.9h vs 19. 8±5.7h,P< 0.001).The incidence of frigidity and cystospasm in group A were higher than that in group B, CONCLUSION Using warm (37℃)irrigating fluid is a practicable and effective measure for controlling the postprostatectomy bleeding.