前列腺汽化电切术后3种方法牵引气囊导尿管的对比研究

赵泽民 孙贵洋 鞠长亮132022吉化集团公司总医院

前列腺汽化电切术后3种方法牵引气囊导尿管的对比研究

赵泽民 孙贵洋 鞠长亮
132022吉化集团公司总医院

目的：探讨经尿道前列腺汽化电切术后，采用牵引固定、大腿内侧胶布固定、纱布结固定气囊导尿管的临床效果。方法：2013年2月-2014年7月收治前列腺增生症患者90例，随机分成牵引固定组、大腿内侧胶布固定组、交替采用纱布结法组，各30例，比较3组临床疗效。结果：牵引固定组在疼痛评估、膀胱冲洗液转清时间、术后情绪评分、拔管时间方面明显低于大腿内侧胶布固定组和交替采用纱布结法组，牵引固定组与大腿内侧胶布固定组和交替采用纱布结法组比较差异有统计学意义(P＜0.05)。牵引固定组发生并发症(压疮)1例，并发症发生率3.3%；大腿内侧胶布固定组发生并发症7例，并发症发生率23.3%，其中下肢静脉血栓1例，尿道外口坏死、狭窄1例，压疮5例；交替采用纱布结法组发生并发症5例，其中下肢静脉血栓1例，尿道外口坏死、狭窄2例，褥疮2例；牵引固定组并发症发生率明显低于大腿内侧胶布固定组和交替采用纱布结法组，差异有统计学意义(P＜0.05)。结论：牵引固定气囊导尿管具有止血快、操作简单、并发症少等优点，值得临床推广。

牵引固定；大腿内侧胶布固定；纱布结固定；气囊导尿管；经尿道前列腺汽化电切术

前列腺增生症是老年男子常见疾病之一，为前列腺的一种良性病变，目前，经尿道前列腺汽化电切术(tTUVP)成为治疗良性前列腺增生的重要方法。但是术后出血是常见的并发症，合理固定气囊导尿管，是降低出血的关键。近年来，我们采用交替采用纱布结固定、大腿内侧胶布固定、牵引固定气囊导尿管的方法进行固定。为探讨其固定效果，2013年2 月-2014年7月收治前列腺增生症患者90例，对其进行总结和分析，现报告如下。

资料与方法

2013年2月-2014年7月收治前列腺增生症患者90例，随机分成牵引固定组、大腿内侧胶布固定组、交替采用纱布结法组，各30例，其中牵引固定组年龄(72.4±8.4)岁，切除的前列腺体重量(32.6±5.6)g；腿内侧胶布固定组年龄(73.5±8.3)岁，切除的前列腺体重量(32.6±5.7)g；纱布结法组年龄(71.5±8.1)岁，切除的前列腺体重量(33.3±5.9)g。3组患者一般资料比较差异无统计学意义(P＞0.05)。

方法：：①牵引固定方法：当患者TUVP术后，将留置的三腔气囊导尿管囊中注水30～50 mL置于膀胱内，牵引导尿管利用导尿管的双腔环流系统进行膀胱冲洗，同时利用使水囊压迫前列腺窝进行止血。②大腿内侧胶布固定法：用医用胶布缠绕三腔导尿管粘贴在患者一侧大腿皮肤上。③纱布结法：将小纱布打结后压迫尿道外口。

统计学方法：所有数据采用SPSS 16.0进行统计分析，计量资料用(±s)表示，采用t检验；计数资料采用χ2检验；P＜0.05为差异具有统计学意义。

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