摘要
目的对经尿道前列腺增生手术的患者术后纤溶系统过度激活的发生情况和危险因素进行分析。方法回顾性分析2015年11月至2018年12月我院接受经尿道前列腺手术的患者101例,年龄56~88岁,平均(69.7±3.3)岁。将患者术前日晨及术后首日晨7点抽血查凝血象纳入分析。结果纤溶过度激活组患者32例(31.7%),纤溶正常组69例(68.3%),两组间术前术后血红蛋白改变、术后凝血酶原、术后纤维蛋白定量和术后D二聚体水平有显著性差异(P<0.05)。单因素分析显示手术方式(P=0.002),术前D二聚体水平(P=0.003)与术后纤溶过度激活有相关关系,而年龄、前列腺大小、手术时间与术后纤溶过度激活的发生无相关关系(P>0.05)。多因素分析显示手术方式(OR=3.748)、术前D二聚体水平(OR=0.307)是术后纤溶过度激活的独立影响因素。结论纤溶系统过度激活是导致经尿道前列腺手术术后出血的潜在原因之一,术前D二聚体的检测可以对经尿道前列腺手术围术期纤溶系统过度激活的发生判断有所帮助。
Objective To explore the occurrence and risk factors of hyperfibrinolysis secondary to transurethral resection of prostate(TURP).Methods The clinical data of 101 patients who underwent TURP in our hospital during Nov.2015 and Dec.2018 were retrospectively analyzed.The patients aged 56~88 years,average 69.7±3.3 years.Blood samples were taken at 7 am the day before operation and 7 am the first day after operation.Results There were 32(31.7%)patients in the hyperfibrinolysis group and 69(68.3%)patients in the normal fibrinolysis group.There were significant differences in hemoglobin changes,postoperative thrombin,postoperative fibrinogen quantification and postoperative D-dimer level between the two groups before and after operation(all P<0.05).Univariate analysis showed that surgical approach(P=0.002)and preoperative D-dimer level(P=0.003)were correlated to the occurrence of hyperfibrinolysis,while age,prostate size and operative time were not correlated.Multivariate analysis showed that surgical approach(OR=3.748)and preoperative D-dimer level(OR=0.307)were independent risk factors of postoperative hyperfibrinolysis.Conclusion Hyperactivation of the fibrinolytic system is one of the potential causes of bleeding after TURP.Preoperative D-dimer level can predict the occurrence of hyperactivation of fibrinolytic system.
作者
侯惠民
付春龙
郭潇潇
张大磊
张亚群
刘明
HOU Hui-min;FU Chun-long;GUO Xiao-xiao;ZHANG Da-lei;ZHANG Ya-qun;LIU Ming(Department of Urology,Beijing Hospital,Beijing 100730,China)
出处
《现代泌尿外科杂志》
CAS
2019年第9期719-721,753,共4页
Journal of Modern Urology
关键词
经尿道前列腺切除术
纤溶亢进
出血
transurethral resection of prostate
hyperfibrinolysis
postoperative bleeding
