灌注液高度对前列腺等离子电切术中血流动力学、出血量和手术时间的影响-现代医学

灌注液高度对前列腺等离子电切术中血流动力学、出血量和手术时间的影响

单位：江苏省盐城市第一人民医院手术室, 江苏盐城 224005

分类号：R697+.3

出版年·卷·期（页码）：2017·36·第五期（725-728）

摘要：

目的：探讨前列腺等离子电切术灌注液高度对患者血流动力学、出血量和手术时间的影响。方法：采用临床随机对照试验法，将180例入选前列腺增生电切患者用随机数字表发分为三组（每组60例），观察在不同灌注高度（40 cm、60 cm和80 cm）下三组患者术中不同血流动力学、出血量和手术时间的变化。结果：采用80 cm灌注高度时术中平均动脉压（MAP）及心率（HR）较术前明显提高，血氧饱和度（SPO₂）和术前相比明显降低（P<0.05）。采用40 cm和60 cm灌注高度时术中MAP、HR及SPO₂与术前相比无明显变化（P>0.05）。40 cm灌注高度患者的手术时间和平均出血量明显高于其他两组（P<0.05）；60 cm和80 cm灌注高度两组之间无明显差异。结论：60 cm灌注高度时既可以保证视野清晰，缩短手术时间，减少出血量，同时对患者血流动力学无明显改变，是前列腺等离子电切时最佳的灌洗高度。

Objective: This study mainly investigated the effects of different height of perfusion fluid on hemodynamics, bleeding volume and operative time during transurethral vaporization resection of prostate. Method: 180 patients with benign prostatic hyperplasia were random diveded into three groups:40 cm group, 60 cm group and 80 cm group, and observed the effects of different height of perfusion fluid on hemodynamics, bleeding volume and operative time during transurethral vaporization resection of prostate. Results: Patients with 80 cm height of perfusion fluid could influence the hemodynamics (MAP、HR and SPO₂). However, 40 cm group and 60 cm group had no significant changes in hemodynamics. The operation time and the average bleeding volume of 40 cm group was significantly higher than that of the other two groups. There was also had no significant changes in hemodynamics. Conclusion: Compared with 40 cm group and 80 cm group, patients with 60 cm height of perfusion fluid could obtain clear vision, shorten operation time, and reduce bleeding volume without influence the hemodynamics. 60 cm is the appropriate height of perfusion fluid for patients with transurethral vaporization resection of prostate.

参考文献：

[1] 符少川,马乃全,周期,等.良性前列腺增生患者经尿道双极等离子前列腺电汽化术中血乳酸水平变化及其临床意义[J].中国老年学杂志,2012,32(8):1617-1619.
[2] 白忠原,杨江根,肖克峰,等.等离子前列腺剜除术与前列腺电切术的临床疗效对比分析[J].中国老年学杂志,2010,30(11):1483-1485.
[3] 龚旻,伊庆同,胡巍,等.经尿道前列腺电汽化术及等离子电切术后5年疗效随访[J].中华泌尿外科杂志,2012,33(5):364-368.
[4] 鄢阳,郑军华,彭波,等.经尿道等离子双极前列腺电切和单极前列腺电切治疗前列腺增生(体积>60 ml)的临床研究[J/CD].中华腔镜泌尿外科杂志:电子版,2011,5(2):139-142.
[5] HO HS,YIP S K,LIM K B,et al.A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system[J].Eur Urol,2007,52(2):517-522.
[6] 陈春丽.经尿道前列腺电切术中不同灌洗压力对患者心率、血压的影响观察[J].现代护理,2006,12(2):143-144.
[7] 李露霞,侯宗英,王凤英,等.不同悬挂高度的冲洗液对TURP术影响的观察[J].华西医学,2000,15(4):463.
[8] 秦晓涛.TURP术中膀胱内压的变化及其对冲洗液吸收的影响[D].华西医科大学,1998.
[9] 韩洪涛.经尿道前列腺电切术中不同灌洗压力对患者心率、血压的影响[J].医学理论与实践,2006,19(12):1380.
[10] 唐顺利,钟明,李凯,等.普通电切和双极等离子电切治疗BPH的疗效比较[J].中国男科学杂志,2012,26(5):48-50.
[11] 黄韦歆,张丽琼,熊英.经尿道前列腺等离子电切手术的护理配合体会[J].中国内镜杂志,2008,14(4):446-447.
[12] HAMMADEH M Y,MADAAN S,HINES J,et al.5-year outcome of a prospective randomized trial to compare transurethral electrovaporization of the prostate and standard transurethral esection[J].Urology,2003,61(6):1166-1171.
[13] 柳素霞,刘丽平,郑利云.不同灌注液的量对TURP术后患者康复的影响[J].当代护士,2011(2):95-96.

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