术前急性尿潴留留置导尿管对绿激光前列腺汽化术治疗前列腺增生症的影响

摘要

目的:探讨因急性尿潴留而留置导尿管对经尿道选择性绿激光前列腺汽化术(photoselective vaporization of prostate,PVP)的影响.方法:良性前列腺增生急性尿潴留患者60例,均留置导尿管,随机均分为2组,其中30例拔除导尿管后直接行PVP术(Ⅰ组);30例抗菌及口服药物抑制前列腺增生治疗,拔除导尿管2周后行PVP术(Ⅱ组).比较2组手术时间、术中失血量、术后留置导尿管时间、术后住院时间、术后膀胱冲洗时间、手术前后血红蛋白量变化情况,随访记录国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、剩余尿量(RUV)及各种并发症发生情况.结果:除术后血红蛋白量2组间差异无统计学意义(P>0.05)外,Ⅰ组手术时间、术中出血量、术后留置尿管时间、术后住院时间、术后膀胱冲洗时间均大于Ⅱ组(P0.05).结论:PVP术安全可靠,术前留置导尿管对术中操作有一定影响,使术中出血量增多,易致术中视野模糊,手术时间延长,但对术后临床疗效无明显影响.%Objective: To explore the clinical effects of preoperative indwelling catheter on the photoselective vaporization of prostate ( PVP). Methods: Sixty patients with benign prostatic hyperplasia and acute urinary retention were indwelled catheter and randomly divided into two groups, which included accepting PVP surgery directly after removal the catheter( group Ⅰ ,30 cases) and treatment with anti-inflammatory and oral medication to inhibit prostatic hyperplasia and accepting PVP surgery 2 weeks after removal the catheter ( group Ⅱ ) . The operative time, intraoperative bleeding, postoperative indwelling catheter time, postoperative hospital stay, postoperative bladder irrigation time and the hemoglobin content before and after surgery of two groups were analyzed. The international prostate symptom score(IPSS),life quality score(QOL) ,maximum flow rate(Qmax) ,residual urine volume(RUV) and variety of complications were followed-up and recorded. Results: The postoperative hemoglobin contents of two groups had significant statistical difference ( P > 0.05). The operative time, intraoperative bleeding, postoperative indwelling catheter time, postoperative hospital stay and the postoperative bladder irrigation time of group Ⅰ were longer than that of group Ⅱ ( P 0. 05 ). Conclusions: PVP surgery is safe and reliable. Preoperative indwelling catheter has some effects on operation, which can lead to much bleeding during operation, vision blurry and prolong operative time, and no significantly effects on postoperative.