目的：探讨经皮膀胱穿刺造瘘在经尿道前列腺电切（TURP）术中的临床疗效观察。方法70例良性前列腺增生行TURP术患者按治疗方法分为2组，对照组采用TURP术常规治疗，治疗组采用经皮耻骨上穿刺膀胱造瘘后进行TURP术。术后第2天拔除造瘘管。2组患者分别在TURP术后观察血清Na＋和血红蛋白（ Hb）水平，国际前列腺症状评分（ IPSS）、生活质量（QOL）积分，血压变化，手术时间，出血量，前列腺切除质量、留置导尿管天数等指标。结果2组患者TURP术后血清Na＋和Hb水平均降低，收缩压（ SBP）和舒张压（ DBP）均升高，对照组Na＋和Hb水平降低，SBP和DBP升高，差异有统计学意义（P＜0．05）。与对照组比较，治疗组TURP术后血清Na＋和Hb水平降低，SBP和DBP升高，差异有统计学意义（P＜0．05）。治疗组TURP术手术时间[（53．2±5．8） min]、IPSS积分[（6．05±4．32）分]、QOL积分[1．47±0．28）分]、出血量[（253±11）ml]和留置导尿管天数[（4．3±1．1）d]均减少，切除前列腺质量[（32．5±4．2）g]增加，与对照组[分别为（67．5±6．1）d，（8．37±4．69）分，（3．64±0．31）分，（272±13）ml，（5．6±2．5）d，（26．1±3．7）g]比较差异有统计学意义（P＜0．05）。结论经皮膀胱穿刺造瘘明显减少了TURP术的手术时间、出血量、留置导尿管天数、IPSS、QOL积分，维持血清Na＋，Hb水平和血压，降低TURP术综合征的发生，值得临床推广应用。%Objective To explore the clinical effect of percutaneous bladder puncture colostomy on transurethral prostatecto -my.Methods Seventy cases of benign prostatic hyperplasia that underwent transurethral prostatectomy ( TURP) were randomly divid-ed into 2 groups:the treatment group and the control group .The treatment group received TURP following pubic percutaneous puncture bladder colostomy , while the control group received TURP conventional treatment .Two days after surgery , the fistulas were removed . Serum Na +and Hb levels, IPSS, QOL scores, changes in blood pressure, surgical time, blood loss, weight of resected prostate, days of indwelling catheter retention were detected in the patients of the 2 groups, following TURP treatment.Results Following TURP, ser-um Na+and Hb levels in the patients of both groups all decreased , while systolic blood pressure ( SBP) and diastolic blood pressure (DBP) all increased, and there was statistical significance as compared with those before surgery (P<0.05).Serum Na +and Hb lev-els in the patients of the treatment group were lower than those of the control group , while SBP and DBP levels were higher than those of the control group, with statistical significance(P<0.05).TURP surgical time [(53.2 ±5.8)min], IPSS and QOL scores [(6.05 ± 4.32) ], [1.47 ±0.28)], blood loss [(253 ±11)]ml] and days of indwelling catheter retention [(4.3 ±1.10)d] for the treatment group were all decreased , when compared with those of the control group .Average weight of the resected prostate for the patients in the treatment group was increased [(32.5 ±4.2)g].The levels or scores of the control group were respectively (67.5 ±6.1) d, (8.37 ± 4.69), (3.64 ±0.31), (272 ±13)ml and (5.6 ±2.5)d,(26.1 ±3.7)g], statistical significance could be noted when comparisons were made between the 2 groups(P <0.05).Conclusion Percutaneous puncture Bladder colostomy could obviously decrease the TURP surgical time, blood loss, days of indwelling catheter retention , IPSS and QOL scores, maintain serum Na +and Hb levels and blood pressure and reduce the incidence of TURP syndrome during operation .For this reason , it is worth further clinical extension .
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