Shrestha B M, Prasopshanti K, Matanhelia S S, Peeling W B
Department of Urology, Royal Gwent Hospital, Newport, Gwent, UK.
Kathmandu Univ Med J (KUMJ). 2008 Jul-Sep;6(23):329-34. doi: 10.3126/kumj.v6i3.1707.
Transurethral resection of prostate (TURP) is the gold standard treatment for symptomatic prostatic bladder outlet obstruction. Haemorrhage during and after TURP can lead to significant morbidity and mortality. The purpose of this study was to assess the influence of anaesthesia, operating time, weight of resected prostatic tissue and its histology on blood loss during and after TURP and to revisit the available body of evidence in the literature of urology.
This is a prospective study of a cohort of 100 consecutive patients who had undergone TURP over a period of one year, where the data was collected on a performa specifically designed for the study, which included the type of anaesthesia administered, resection time, amount of blood lost during and after TURP, weight of the resected prostatic tissue and histology.
Sixty seven patients underwent TURP under spinal anaesthesia (SA) and 33 under general anaesthesia (GA). The median intraoperative (SA: 89.95 (5-936); GA: 105.40 (5-517) mls), postoperative (SA: 72.37 (15-387); GA: 136.43 (11-969) mls) and total (SA: 162.32 (29-1200); GA: 241.83 (21-1251) mls) blood losses were not significantly different between the two groups (95% C.I. -9.90 to 19.22, p= 0.46). The total operating time (SA: 29.70 (10-55); GA: 29.80 (10-65) minutes) and weight of resected prostate (SA: 21.90 (3-45); GA: 18.00 (4-60) gms) were similar between the two groups. There was a trend towards increased blood loss when BPH was associated with prostatitis (N=8). Of these, 3 patients required blood transfusion as compared to 1 patient in rest of the group, although this was not statistically significant (95% C.I - 67.2 to 1120.4, p = 0.87).
The intraoperative, postoperative and total blood losses related to TURP were not influenced by the type of anaesthesia, resection time, weight of the resected prostate and the histology.
经尿道前列腺切除术（TURP）是治疗有症状的前列腺膀胱出口梗阻的金标准。TURP术中及术后出血可导致严重的发病率和死亡率。本研究的目的是评估麻醉、手术时间、切除的前列腺组织重量及其组织学对TURP术中及术后失血的影响，并重新审视泌尿外科文献中的现有证据。
这是一项对100例连续患者进行的前瞻性队列研究，这些患者在一年时间内接受了TURP手术，数据收集在专门为该研究设计的表格上，包括所采用的麻醉类型、切除时间、TURP术中及术后失血量、切除的前列腺组织重量和组织学。
67例患者在蛛网膜下腔麻醉（SA）下接受TURP，33例在全身麻醉（GA）下接受TURP。两组患者术中（SA：89.95（5 - 936）；GA：105.40（5 - 517）毫升）、术后（SA：72.37（15 - 387）；GA：136.43（11 - 969）毫升）和总失血量（SA：162.32（29 - 1200）；GA：241.83（21 - 1251）毫升）无显著差异（95%置信区间 - 9.90至19.22，p = 0.46）。两组患者的总手术时间（SA：29.70（10 - 55）；GA：29.80（10 - 65）分钟）和切除前列腺的重量（SA：21.90（3 - 45）；GA：1e.00（4 - 60）克）相似。当良性前列腺增生（BPH）合并前列腺炎时（N = 8），有失血增加的趋势。其中，与该组其他患者中的1例相比，有3例患者需要输血，尽管这在统计学上无显著差异（95%置信区间 - 67.2至1120.4，p = 0.87）。
与TURP相关的术中、术后及总失血量不受麻醉类型、切除时间、切除前列腺的重量和组织学的影响。
