膀胱内缝扎前列腺动脉、膀胱颈口连续缝合在耻骨上前列腺切除术中的应用  

Application of Prostatic Artery Ligation in Bladder and Continuous Suture of the Bladder Neck in Suprapubic Prostatectomy

作　　者：周发友[1] 王玉清[1] 万水[1] 耿勇[1] 谷炎 

机构地区：[1]安徽省芜湖市中医院泌尿外科,安徽芜湖241000

出　　处：《昆明医学院学报》2010年第9期125-127,共3页Journal of Kunming Medical College

摘　　要：目的探讨耻骨上经膀胱前列腺切除术中防止出血的有效方法.方法对42例前列腺增生症患者在耻骨上前列腺切除时作膀胱内5点、7点处前列腺动脉缝扎、前列腺切除后温盐水纱布填塞前列腺窝5min,用1-0肠线连续环行缝合前列腺窝膀胱颈创缘1周.结果手术时间50～110 min,平均70 min,术中出血85～140 mL,平均120 mL,无输血病例.术后1～2 d膀胱冲洗液转清,3～5 d拔除造瘘管,7～10 d拔除尿管后自行排尿通畅,术后住院时间9～12 d,平均10 d.随访1 a,轻度尿失禁者3例,2～3月恢复尿控,无明显性功能障碍及继发性出血病例.结论在耻骨上前列腺切除术时,作膀胱内前列腺动脉缝扎、膀胱颈口连续缝合,具有安全、出血量少、疗效确切、手术简便、恢复快等优点.Objective To explore the clinical effective methods to prevent hemorrhage during suprapubic transvesical prostatectomy.Methods Forty-two patients with benign prostatic hyperplasia received suprapubic prostatectomy via bladder.During the operation,we ligated the prostatic artery on 5 and 7 points in bladder and used warm saline gauze packed the prostate fossa for 5 mins,after that we used a 1-0 cat gut to suture continuously the edge of the prostate fossa and the bladder neck for one circle.Results The operation time was 50～110 mins,the average tiem was 70 mins.The blood loss volume was 85～140 mL,average 120 mL,and no blood transfusion case.Bladder irrigation solution turned clear 1～2 d after operation,the fistula was removed 3～5 d after operation,the catheter was removed 7～10 d after operation.The postoperative hospital stays time was 9～12 d,average 10 d.Patients were Followed up for 1 year,3 patients had mild urinary incontinence,and restored urinary control in 2 to 3 months,no obvious sexual dysfunction and secondary hemorrhage was found in patients.Conclusion During the suprapubic prostatectomy,prostatic artery ligation in bladder and continuous suture of the edge of the prostate fossa and the bladder neck has many advantages,such as safety,less blood loss,exact effects and quick recovery.

关 键 词：前列腺增生症 耻骨上前列腺切除术 止血 

分 类 号：R697.3[医药卫生—泌尿科学]