摘要
目的探讨尿道前列腺等离子剜除术(PKEP)中出血量和术后膀胱痉挛与逼尿肌功能状态的关系。方法以115例行PKEP的良性前列腺增生症(BPH)患者为研究对象。按照术前膀胱逼尿肌稳定状态分为逼尿肌稳定组51例和逼尿肌不稳定组64例,比较两组术中出血量和术后膀胱痉挛情况;再将逼尿肌不稳定组按照逼尿肌收缩强度分为正常组、减弱组和亢进组,分析逼尿肌收缩强度与术中出血量和术后膀胱痉挛程度的关系。结果 115例中,逼尿肌不稳定患者64例,占55.65%;逼尿肌不稳定组术中出血量和术后膀胱痉挛发生率均高于逼尿肌稳定组(P <0.05)。逼尿肌亢进组的术中出血量、膀胱痉挛发生率和膀胱痉挛程度评分均高于正常组和减弱组(P <0.05);减弱组的术中出血量、膀胱痉挛发生率和膀胱痉挛程度评分均低于正常组(P <0.05)。结论 BPH患者PKEP术中出血量和术后膀胱痉挛与术前逼尿肌稳定状态密切相关。逼尿肌收缩强度越大,术中出血量越大,术后膀胱痉挛发生率越高,且痉挛程度越严重。因此,临床可通过术前测定BPH患者逼尿肌功能状态,实施针对性的干预措施,以减少术中出血量和术后膀胱痉挛的发生。
Objective To explore the correlation between the amount of bleeding during transurethral plasma prostatectomy(PKEP) and postoperative bladder spasm and detrusor function status. Methods A total of 115 patients with benign prostatic hyperplasia(BPH) to receive PKEP were selected as study subjects, and they were divided into a stable detrusor group(n=51) and an unstable detrusor group(n=64) according to the preoperative stable state of detrusor of bladder. The intraoperative amount of bleeding and the postoperative bladder spasm were compared between the two groups. The unstable detrusor group was further divided into a normal group, an attenuated group and a hyperactive group according to the contraction intensity of detrusor in order to analyze the correlation between the contraction intensity of detrusor and the intraoperative amount of bleeding and the degree of postoperative bladder spasm. Results There were 64 patients with unstable detrusor among the 115 patients, accounting for 55.65%; the intraoperative amount of bleeding and the incidence of postoperative bladder spasm in the unstable detrusor group were higher than those in the stable detrusor group(P < 0.05). The intraoperative amount of bleeding, the incidence of bladder spasm and the scores of bladder spasm degree in the hyperactive detrusor group were higher than those in the normal group and the attenuated group(P <0.05). The intraoperative amount of bleeding, the incidence of bladder spasm and the scores of bladder spasm degree in the attenuated group were lower than those in the normal group(P < 0.05). Conclusion The intraoperative amount of bleeding during PKEP and postoperative bladder spasm in patients with BPH are closely correlated to the preoperative stable state of detrusor. The higher the contraction intensity of detrusor is, the greater the intraoperative amount of bleeding, the higher incidence of postoperative bladder spasm and the more severe the spasm will be. Therefore, targeted interventions can be clinically implemented by determin
作者
张学才
Zhang Xuecai(Department of Urinary Surgery,Huili People's Hospital,Huili,Sichuan,615100,China)
出处
《西南国防医药》
CAS
2018年第12期1171-1173,共3页
Medical Journal of National Defending Forces in Southwest China
