南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (01): 131-.

• • 上一篇    下一篇

膀胱造瘘术对于80 g以下良性前列腺增生症双极前列腺电切术患者围手术期的临床意义

龙其成，于哲，林光正，陈鹏亮，魏强，谭万龙   

  • 出版日期:2016-01-20 发布日期:2016-01-20

Value of suprapubic cystostomy in bipolar transurethral resection of the prostate for
benign prostatic hyperplasia below 80 gram

  • Online:2016-01-20 Published:2016-01-20

HTML

PDF

1567

摘要： 目的评估膀胱造瘘术对于80 g以下良性前列腺增生症（BPH）的患者行双极经尿道前列腺电切术（双极TURP）的围手术
期获益情况。方法收集南方医院2012年1月~2015年10月采用双极TURP治疗80 g以下BPH的病例资料进行回顾性分析。
根据双极TURP术中是否行膀胱造瘘术分为膀胱造瘘组和非膀胱造瘘组，比较两组之间的手术安全性、手术效率、并发症及护
理时间。结果符合纳入标准的病例共585例，其中膀胱造瘘组366例，非膀胱造瘘组219例。造瘘组和非造瘘组手术前后的血
钠浓度、血细胞比容及血红蛋白的下降量分别为0.06±2.92 mmol/L和0.54±3.64 mmol/L；（2.44±4.01）%和（2.89±4.05）%；9.62±
12.81 g/L 和10.42±8.31 g/L，两组间比较均无统计学差异（P>0.05）。两组的前列腺切除重量分别为42.50±12.39 g 和43.76±
12.23 g，两组间比较也无统计学差异（P>0.05）。而造瘘组具有更长的手术时间90.75±40.78 min vs 76.28±32.60 min，差异具有
统计学意义（P<0.05）。两组间的输血率、术后发热率及术后堵管率的比较无统计学差异（P>0.05）。与非造瘘组相比，造瘘组具
有更长的膀胱冲洗时间、尿管留置时间及术后住院时间，分别为3.15±1.44 d vs 2.57±0.89 d；5.19±1.41 vs 4.15±1.13 d；7.36±
2.09 d vs 5.65±1.36 d，两组间的差异具有统计学意义（P<0.05）。结论对于80 g以下的BPH，行膀胱造瘘术会增加手术时间、
膀胱冲洗时间、尿管留置时间及术后住院时间，降低了手术效率，对于双极TURP围手术期未见明显益处。

Abstract: Objective To investigate the perioperative benefit of suprapubic cystostomy in bipolar transurethral resection of the
prostate (B-TURP) for treatment of benign prostatic hyperplasia (BPH) below 80 g. Methods This retrospective study was
conducted in patients undergoing B-TURP for BPH below 80 g, who were stratified with respect of suprapubic cystostomy in
B-TURP. The end points including the safety, efficiency, complications and nursing care were compared between the two
groups. Results A total of 585 patients were enrolled, including 366 in cystostomy group and 219 in non-cystostomy group.
The two groups showed similar postoperative reduction of serum sodium (0.06 vs 0.54 mmol/L, P>0.05), hematocrict (2.44% vs
2.89%, P>0.05), and blood hemoglobin concentration (9.62 vs 10.42 g/L, P>0.05), with comparable weight of resected prostate
(42.50 vs 43.76 g, P>0.05). The operation time was significantly longer in cystostomy group than in non-cystostomy group
(90.75 vs 76.28 min, P<0.05), but the rate of blood transfusion and incidences of postoperative fever and catheter blocking were
comparable between the two groups. Compared with the non-cystostomy group, cystostomy group had significantly longer
time for bladder washing (3.15 vs 2.57 days, P<0.05), catheter indwelling time (5.19 vs 4.15 days, P<0.05), and hospital stay after
the operation (7.36 vs 5.65 days, P<0.05). Conclusions In B-TURP for BPH below the weight of 80 g, suprapubic cystostomy is
associated with a longer time for operation, bladder washing, catheter indwelling and postoperative hospital stay, and thus
provides no obvious benefits for the patients.