摘要
目的:评估围术期止血药物对经尿道前列腺等离子双极电切术(PKRP)患者围术期出血及短期预后的影响。方法:回顾性分析520例PKRP患者,根据围术期是否使用止血药物分为止血组(n=294)和未止血组(n=226)。记录两组围术期总血液丢失量、切除前列腺重量、术后血红蛋白(HB)、术后膀胱冲洗时间、术后住院时间和术后尿管留置时间,随访3个月尿潴留、血尿、尿路感染及尿道狭窄的发生率。结果:两组围术期总血液丢失量、切除前列腺重量、术后膀胱冲洗时间及术后住院时间比较差异均无统计学意义(P>0. 05)。止血组随访3个月最大尿流率(Qmax)和国际前列腺症状评分(IPSS评分)分别为(15. 2±3. 9)mL/s、(6. 8±4. 8)分,未止血组分别为(14. 5±4)mL/s、(6. 9±4. 8)分,以上指标比较均无统计学意义(P>0. 05)。两组术后并发症尿潴留、尿路感染、血尿及尿道狭窄的发生率未见明显差异(P>0. 05)。多元线性回归分析结果显示总血液丢失量与切除前列腺重量相关(R^2=0. 058,P<0. 05),即切除体积越大,总血液丢失量越多。结论:PKRP治疗BPH的短期疗效及安全性是显著的,围术期止血药物的使用对PKRP患者围术期出血以及短期预后无明显影响。
Objective: To evaluate the effect of perioperative hemostatic drugs on the perioperative hemorrhage and short-term prognosis of plasmakinetic resection of prostate(PKRP).Methods: A total of 520 patients with PKRP were retrospectively analyzed and divided into two groups according to whether hemostatic drugs were used in perioperative period, namely, the hemostatic group(n=294)and the unhemostatic group(n=226). We collect total perioperative blood loss, blood loss per gram(g) of tissue, weight of prostatectomy, postoperative hemoglobin(HB), postoperative bladder irrigation time, postoperative hospital stay,postoperative urinary catheter indwelling time, as well as the incidence of urinary retention, hematuria, urinary tract infection and urethral stricture was followed up for 3 months.Results: No significant difference in the total perioperative blood loss,weight of prostatectomy, postoperative bladder irrigation time and postoperative hospital stay were found between the hemostasis group and unhemostasis group(P>0. 05 for all). The maximum urine flow rate(Qmax)and international prostate symptom scores(IPSS) were(15. 2±3. 9) mL/s and(6. 8±4. 8) in the hemostasis group, and(14. 5±4. 0) mL/s and(6. 9±4. 8) in the unhemostasis group, respectively,without significant difference(P>0. 05 for both indices). The incidence of postoperative complications such as urinary retention, urinary tract infection, hematuria and urethral stricture also had no statistically significant difference between the two groups(P>0. 05 for all). By the multiple linear regression analysis, the total blood loss was correlated with the weight of prostate resection(R^2=0. 058, P<0. 05).Conclusion: The short-term efficacy and safety of PKRP for BPH are remarkable. Perioperative hemostatic drugs had no significant effect on perioperative bleeding and short-term prognosis in PKRP patients.
作者
肖观发
熊晶
龚侃
贺大林
刘孝华
石胜军
陈赵
刘同族
王行环
胡万里
XIAO Guanfa;XIONG Jing;GONG Kan;HE Dalin;LIU Xiaohua;SHI Shengjun;CHEN Zhao;LIU Tongzu;WANG Xinghuan;HU Wanli(Dept.of Urology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Dept.of Urology,Peking University First Hospital,Beijing 100034,China;Dept.of Urology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China;Dept.of Urology,University Hospital of Hubei University for Nationalities,Enshi 445000,Hubei,China;Chongqing People's Hospital,Chongqing 400013,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第3期444-447,共4页
Medical Journal of Wuhan University
基金
国家重点研发计划项目(编号:2016YFC0106300)
作者简介
肖观发,男,1995-,医学硕士生,主要从事前列腺增生相关研究,E‑mail:m15827349396@163.com;通讯作者:胡万里,男,1974-,副教授,主任医师,主要从事前列腺增生、男性性功能障碍等研究,E‑mail:92011552730@sina.com
