Clinical investigation of transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia with blood platelet mild decreasing
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摘要: 目的:研究经尿道等离子电切术(PKRP)治疗伴有轻度血小板(PLT)减少的良性前列腺增生(BPH)临床安全及可行性。方法:回顾性分析PKRP治疗BPH伴PLT轻度减少54例(PLT减少组),年龄53~85岁,前列腺体积24~125 mL。PLT计数51~89×109/L,平均(73.4±10.9)×109/L,3例(PLT<52×109/L)给予提升PLT治疗。将同期入院PLT正常前列腺增生患者54例作为对照组,年龄59~87岁,前列腺体积24~163 mL。两组患者术前凝血无异常。比较两组术中及术后出血、手术时间、手术前后血红蛋白减少量、膀胱冲洗时间、拔管时间及排尿困难解除情况。结果:两组手术均顺利完成。PLT减少组患者手术时间41~266 min,平均(106.9±38.0) min;手术前后血红蛋白减少4~40 g/L,平均(9.9±6.0) g/L;膀胱冲洗15~70 h,平均(31.2±12.7) h;拔管时间3.5~7 d,平均(5.0±0.7) d;术后2例输血,3例短期尿潴留,治疗后好转。对照组患者手术时间40~210 min,平均(103.9±36.1) min;手术前后血红蛋白减少3~32 g/L,平均(10.8±6.6) g/L;膀胱冲洗16~162 h,平均(36.3±22.6) h;拔管时间3.5~9.0 d,平均(5.1±1.0) d;术后3例出血,其中1例手术止血,均无输血;4例尿潴留,2例治疗后好转。两组术中术后出血、手术时间、手术前后血红蛋白减少量、膀胱冲洗时间、尿管拔除时间及排尿困难解除比较差异无统计学意义(P>0.05)。结论:对伴有轻度PLT减少的BPH患者,PKRP是安全可行的。Abstract: Objective: To investigate the clinical safety and feasibility of the transurethral plasmakinetic resection of prostate(PKRP) for benign prostatic hyperplasia(BPH) with mild blood platelet(PLT) decreasing. Method: We analyzed retrospectively 54 BPH patients with mild thrombocytopenia undergoing PKRP whose age was 53 to 85 years old. Their prostate volume was 24 to 125 mL. The PLT ranges 51×109 to 89×109/L, average was(73.4±10.9)×109/L. Three cases(PLT<52×109/L) have the treatment of elevating platelet. Another 54 simultaneous BPH with normal PLT were the control group(age 59-87, prostate volume 24-163 mL). The two groups had normal preoperative coagulogram. Intraoperative and postoperative bleeding(I/PB), operative time(OT), decreasing volume of the hemoglobin(DVH), bladder irrigation time(BIT), removing urine catheter time(RUT) and improving dysuria(ID) were compared between two groups. Result: The operation succeed in two groups. The OT of the patients with mild PLT decreasing was 41-266 min(average 106.9±38.0 min), DVH was 4-40 g/L(average 9.9±6.0 g/L), BIT was 15-70 h(average 30.9±12.7 h) and RUT was 3.5-7.0 d(average 5.0±0.7 d). Two patients needed blood transfusion postoperatively. Three patients had transient urine retention, then they recovered after potent treatment. In control group, the OT was 40-210 min(average 103.9±36.1 min), DVH was 3-32 g/L(average 10.8±6.6 g/L), BIT was 16-162 h(average 36.3±22.6 h) and RUT was 3.5-9.0 d(average 5.1±1.0 d). Three patients were found bleeding postoperatively. One of them needed hemostatic operation, but no one needed blood transfusion. Four patients were found urine retention, then two of them recovered after potent treatment. No obvious significance was found between two groups in I/PB,OT, DVH, BIT,RUT and ID(P>0.05).Conclusion: For BPH patients with mild thrombocytopenia, PKRP is safe and feasible.
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