机器人辅助腹腔镜前列腺癌根治术后三腔导尿管最佳引流方式的研究

The best drainage method of three-cavity catheter after robot-assisted laparoscopic radical prostatectomy

  • 摘要:
    目的 探讨机器人辅助腹腔镜前列腺癌根治术后三腔导尿管的最佳引流方式。
    方法 选取行机器人辅助腹腔镜前列腺癌根治术的120例患者,按照手术先后顺序分为观察组60例和对照组60例。观察组术后三腔导尿管实行双通道引流,对照组实行单通道引流。比较2组患者术后急性尿潴留、吻合口瘘、肠梗阻发生情况; 比较2组患者术后盆腔引流管、三腔导尿管的留置时间及术后平均住院时间; 采用焦虑自评量表(SAS)评价2组患者术后的焦虑状态。
    结果 观察组术后发生急性尿潴留12例(20.00%)、吻合口瘘5例(8.33%)、肠梗阻2例(3.33%); 对照组术后发生急性尿潴留25例(41.67%)、吻合口瘘13例(21.67%)、肠梗阻5例(8.33%)。2组患者术后急性尿潴留、吻合口瘘发生率比较,差异有统计学意义(P<0.05)。观察组术后盆腔引流管留置时间(3.62±0.96) d, 三腔导尿管留置时间(11.98±3.26) d, 术后平均住院时间(5.23±0.81) d, 术后SAS评分(56.73±4.65)分,分别短于或低于对照组的(4.53±1.65) d、(13.72±4.26) d、(6.25±1.99) d、(58.93±7.19)分,差异均有统计学意义(P<0.05)。
    结论 机器人辅助腹腔镜前列腺癌根治术后三腔导尿管的最佳引流方式是双通道引流,可以降低术后急性尿潴留和吻合口瘘的发生率,缩短盆腔引流管及三腔导尿管的留置时间,缩短术后平均住院时间,减轻患者术后焦虑水平。

     

    Abstract:
    Objective To explore the best draining method of three-cavity catheter after robot-assisted laparoscopic radical prostatectomy.
    Methods A total of 120 patients with robot-assisted laparoscopic radical prostatectomy were selected and divided into observation group (n=60) and control group (n=60) according to operation sequence. The observation group received double channel drainage with three-cavity catheter after operation, while the control group received single channel drainage. The incidence conditions of acute urinary retention, anastomotic leakage and intestinal obstruction after operation were compared between the two groups; the indwelling time of pelvic drainage tube and three-cavity urinary catheter and the average postoperative hospital stay were compared between the two groups; the Self-rating Anxiety Scale (SAS) was used to evaluate the postoperative anxiety status of patients in both groups.
    Results In the observation group, there were 12 cases of acute urinary retention occurred (20.00%), 5 cases of anastomotic leakage (8.33%) and 2 cases of intestinal obstruction (3.33%); in the control group, there were 25 cases of acute urinary retention (41.67%), 13 cases of anastomotic leakage (21.67%) and 5 cases of intestinal obstruction (8.33%). There were significant differences in incidence rates of acute urinary retention and anastomotic leakage between the two groups (P < 0.05). In the observation group, the indwelling time of pelvic drainage tube, the indwelling time of three-cavity catheter, the average postoperative hospital stay and the postoperative SAS score were (3.62±0.96) days, (11.98±3.26) days, (5.23±0.81) days and (56.73±4.65) points respectively, which were significantly shorter or lower than (4.53±1.65) days, (13.72±4.26) days, (6.25±1.99) days and (58.93±7.19) points in the control group (P < 0.05).
    Conclusion The best drainage method of three-cavity catheter after robot-assisted laparoscopic radical prostatectomy is double channel drainage, which can reduce the incidence rate of postoperative acute urinary retention and anastomotic leakage, shorten the indwelling time of pelvic drainage tube and three-cavity catheter, shorten the average postoperative hospital stay, and relieve the postoperative anxiety level of patients.

     

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