趙澤民 孫貴洋 鞠長(zhǎng)亮132022吉化集團(tuán)公司總醫(yī)院

前列腺汽化電切術(shù)后3種方法牽引氣囊導(dǎo)尿管的對(duì)比研究

趙澤民 孫貴洋 鞠長(zhǎng)亮
132022吉化集團(tuán)公司總醫(yī)院

目的：探討經(jīng)尿道前列腺汽化電切術(shù)后，采用牽引固定、大腿內(nèi)側(cè)膠布固定、紗布結(jié)固定氣囊導(dǎo)尿管的臨床效果。方法：2013年2月-2014年7月收治前列腺增生癥患者90例，隨機(jī)分成牽引固定組、大腿內(nèi)側(cè)膠布固定組、交替采用紗布結(jié)法組，各30例，比較3組臨床療效。結(jié)果：牽引固定組在疼痛評(píng)估、膀胱沖洗液轉(zhuǎn)清時(shí)間、術(shù)后情緒評(píng)分、拔管時(shí)間方面明顯低于大腿內(nèi)側(cè)膠布固定組和交替采用紗布結(jié)法組，牽引固定組與大腿內(nèi)側(cè)膠布固定組和交替采用紗布結(jié)法組比較差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)。牽引固定組發(fā)生并發(fā)癥(壓瘡)1例，并發(fā)癥發(fā)生率3.3%；大腿內(nèi)側(cè)膠布固定組發(fā)生并發(fā)癥7例，并發(fā)癥發(fā)生率23.3%，其中下肢靜脈血栓1例，尿道外口壞死、狹窄1例，壓瘡5例；交替采用紗布結(jié)法組發(fā)生并發(fā)癥5例，其中下肢靜脈血栓1例，尿道外口壞死、狹窄2例，褥瘡2例；牽引固定組并發(fā)癥發(fā)生率明顯低于大腿內(nèi)側(cè)膠布固定組和交替采用紗布結(jié)法組，差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)。結(jié)論：牽引固定氣囊導(dǎo)尿管具有止血快、操作簡(jiǎn)單、并發(fā)癥少等優(yōu)點(diǎn)，值得臨床推廣。

牽引固定；大腿內(nèi)側(cè)膠布固定；紗布結(jié)固定；氣囊導(dǎo)尿管；經(jīng)尿道前列腺汽化電切術(shù)

前列腺增生癥是老年男子常見(jiàn)疾病之一，為前列腺的一種良性病變，目前，經(jīng)尿道前列腺汽化電切術(shù)(tTUVP)成為治療良性前列腺增生的重要方法。但是術(shù)后出血是常見(jiàn)的并發(fā)癥，合理固定氣囊導(dǎo)尿管，是降低出血的關(guān)鍵。近年來(lái)，我們采用交替采用紗布結(jié)固定、大腿內(nèi)側(cè)膠布固定、牽引固定氣囊導(dǎo)尿管的方法進(jìn)行固定。為探討其固定效果，2013年2 月-2014年7月收治前列腺增生癥患者90例，對(duì)其進(jìn)行總結(jié)和分析，現(xiàn)報(bào)告如下。

資料與方法

2013年2月-2014年7月收治前列腺增生癥患者90例，隨機(jī)分成牽引固定組、大腿內(nèi)側(cè)膠布固定組、交替采用紗布結(jié)法組，各30例，其中牽引固定組年齡(72.4±8.4)歲，切除的前列腺體重量(32.6±5.6)g；腿內(nèi)側(cè)膠布固定組年齡(73.5±8.3)歲，切除的前列腺體重量(32.6±5.7)g；紗布結(jié)法組年齡(71.5±8.1)歲，切除的前列腺體重量(33.3±5.9)g。3組患者一般資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。

方法：：①牽引固定方法：當(dāng)患者TUVP術(shù)后，將留置的三腔氣囊導(dǎo)尿管囊中注水30～50 mL置于膀胱內(nèi)，牽引導(dǎo)尿管利用導(dǎo)尿管的雙腔環(huán)流系統(tǒng)進(jìn)行膀胱沖洗，同時(shí)利用使水囊壓迫前列腺窩進(jìn)行止血。②大腿內(nèi)側(cè)膠布固定法：用醫(yī)用膠布纏繞三腔導(dǎo)尿管粘貼在患者一側(cè)大腿皮膚上。③紗布結(jié)法：將小紗布打結(jié)后壓迫尿道外口。

統(tǒng)計(jì)學(xué)方法：所有數(shù)據(jù)采用SPSS 16.0進(jìn)行統(tǒng)計(jì)分析，計(jì)量資料用(±s)表示，采用t檢驗(yàn)；計(jì)數(shù)資料采用χ2檢驗(yàn)；P＜0.05為差異具有統(tǒng)計(jì)學(xué)意義。

Comparative study on the three methods of balloon catheter traction after transurethral resection of the prostate

Zhao Zemin,Sun Guiyang,Ju Changliang
General Hospital of Jilin Chemical Group Company 132022

Objective:To investigate the clinical effect of fixed with traction,inner thighs adhesive tape fixed,gauze node fixed balloon catheter after the transurethral electrovaporization of the prostate,Methods:90 patients with benign prostatic hyperplasia were selected from February 2013 to July 2014.They were randomly divided into the traction fixation group,the inner thighs adhesive tape fixed group,the alternating with gauze node group with 30 cases in each group.We compared the clinical effect of 3 groups.Results:Traction fixation group in the assessment of pain,bladder irrigation fluid clear time,postoperative emotional score, extubation time was significantly lower than those of the inner thigh adhesive tape fixed group and the alternating with gauze node method group;the traction fixation group and the inner thighs adhesive tape fixed group and the alternating with gauze node group with statistically significant(P＜0.05).The traction fixation group occurred 1 case of complications(sore),the complication rate was 3.3%;the inner thigh adhesive tape fixed group occurred 7 cases of complications,the complication rate was 23.3%,of which 1 case of lower extremity venous thrombosis,urethral outside the mouth necrosis,stenosis in 1 case,5 cases of pressure sore;the alternating with gauze node group occurred 5 cases of complications,including 1 case of lower extremity venous thrombosis,the external urethral orifice necrosis,stenosis in 2 cases,2 cases of pressure sore;the complication rate of the traction fixed group was significantly lower than that of the inner thigh adhesive tape fixed group and alternating with gauze node method group,there were statistically significant(P＜0.05).Conclusion:Traction fixed balloon catheter has the advantages of simple operation,quick hemostasis,less complication,so it is worth the clinical promotion.

Traction fixation;The inner thigh adhesive plaster;Gauze junction fixation;Balloon catheter;Transurethral electrovaporization of the prostate

10.3969/j.issn.1007-614x.2015.8.90