经尿道前列腺电切除术后早期不同速度交替膀胱冲洗的效果比较  

Comparison of the effect of different speed of bladder irrigation after transurethral resection of prostate

作　　者：黄咏梅[1] 江红梅[1] 

机构地区：[1]浙江省常山县人民医院护理部,324200

出　　处：《中国基层医药》2016年第3期450-453,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较经尿道前列腺电切除术后不同速度交替膀胱冲洗的应用效果。方法将477例良性前列腺增生症行经尿道前列腺切除术患者，按手术日期分为观察组（单日，249例）与对照组（双日，228例）。两组均采用常温0．9％氯化钠注射液冲洗，对照组采用常规膀胱冲洗速度冲洗，观察组采用早期快速（不限速开放式）与常规速度交替冲洗。比较两组膀胱痉挛发生频率、发作时间、膀胱出血情况及24h心率、平均动脉压变化。结果观察组尿液转清时间、冲洗液总量、术后5d红细胞计数[（19．8±8．3）h、（44．7±6．1）L、（25．8±11．3）何此]均明显低于对照组[（25．4±9．0）h、（52．3±7．4）L、（33．4±10．1）个／μL]，差异均有统计学意义（t=-6．270、-2．417、-10．459，均P〈0．05）；观察组膀胱痉挛发生率、人均发作次数及持续时间[24．5％、（2．2±0．6）次、（15．4±4．6）min]均明显低于对照组[46．9％、（6．7±1．2）次、（27．6±5．1）min]，差异均有统计学意义（X2=8．725、t=-13．250、t=-18．066，均P〈0．05）；两组患者术后冲洗1h、术后2h及术后24h心率、平均动脉压差异均无统计学意义（均P〉0．05）。结论早期快速与常规速度交替冲洗方式能改善前列腺切除患者术后膀胱痉挛的发作，减少膀胱出血。Objective To explore the effect of different speed of bladder irrigation after transurethral resection of prostate. Methods 477 cases of benign prostatic byperplasia, who received transurethral resection surgery were collected. According to the date of surgery,they were divided into observation group（ in a single day,249 cases） and control group （ double day, 228 cases）. The normal saline was used in the two groups, and the control group was washed with the conventional bladder irrigation, and the observation group was treated with the early rapid （no speed limit opening） and the routine velocity alternating flushing. The incidence of bladder spasm,the incidence of bladder spasm,the bleeding of bladder and the changes of heart rate and the mean arterial pressure of 24h were compared. Results Urine turned clear time,the total fluid,postoperative 5d red blood cell count of the observation group[ （ 19. 8 ± 8. 3） h, （44.7 ±6.1 ） L, （25.8 ± 11.3 ） months/IxL ] were significantly lower than the control group [ （ 25.4 ±9.0 ） h, （52.3 ±7.4）L, （33.4 ± 10.1 ）months/tzL] , the differences between the two groups were statistically significant（ t = - 6. 270, - 2. 417, - 10.459, all P 〈 0.05 ）. The incidence rate of bladder spasm, seizure frequency and duration per capita of the observation group [ 24.5%, （ 2.2 ± 0.6 ） times, （ 15.4 ± 4.6 ） min ] were significantly lower than the control group[ 46.9%, （6.7± 1.2）times, （27.6± 5.1 ）min ], the differences between the two groups were statistically significant （ X2 = 8. 725,t = - 13. 250, t = - 18. 066, all P 〈 0.05 ）. The postoperative rinse 1 h, 2h and 24h heart rate, mean arterial blood pressure had no statistically significant differences （ all P 〉 0.05 ）. Conclusion The early rapid and conventional alternating washing method can improve the seizure of bladder spasm after prostatectomy, and reduce the bleeding of bladder.

关 键 词：前列腺切除术 尿道 膀胱 冲洗 痉挛 出血 

分 类 号：R699.8[医药卫生—泌尿科学]