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目的了解前列腺增生(BPH)患者前列腺特异性抗原(PSA)与经尿道前列腺切除术(TURP)中出血量的关系。方法对127例入院手术的BPH患者进行术前血清PSA测定和手术中出血量。127例患者中PSA<4ng/ml患者41例(以下称A组)。PSA4～10ng/ml的患者53例(以下称B组)。PSA>10ng/ml的患者33例,其中急性尿潴留10例,留置尿管持续引流2周后测PSA>10ng/ml(以下称C组)。结果 C组TURP术中出血量、灌洗液量、电切操作时间、术者对术中视野的满意度、以及术后生理盐水连续冲洗膀胱的时间和所消耗的冲洗液量与对照组比较,差异均有统计学意义(P<0.05),而术中的输血率、TURS的发生率、术后1个月内继发性出血的发生率经比较,差异均无统计学意义(P>0.05)。B组除术后生理盐水连续冲洗膀胱的时间和所消耗的冲洗液量与A组比较,差异有统计学意义外(P<0.01),其他临床观察指标的差异均无统计学意义(P>0.05)。结论 PSA水平高的患者TURP术中出血量多。
Objective To investigate the relationship between prostate-specific antigen (PSA) and bleeding in transurethral resection of prostate (TURP) in patients with benign prostatic hyperplasia (BPH). Methods 127 cases of BPH patients admitted to hospital for preoperative serum PSA measurement and blood loss during surgery. In 127 patients with PSA <4ng / ml in 41 patients (hereinafter referred to as A group). 53 patients with PSA4 ~ 10ng / ml (hereinafter referred to as group B). Thirty-three patients with PSA> 10ng / ml had acute urinary retention in 10 cases and PSA> 10ng / ml (hereinafter referred to as group C) after 2 weeks of continuous catheter drainage. Results In group C, the amount of bleeding, the volume of lavage fluid, the operation time of electrosurgery, the degree of satisfaction of intraoperative visual field and the time of continuous flushing of bladder with saline after operation in group C were compared with that of control group (P <0.05), while the intraoperative blood transfusion rate, the incidence of TURS and the incidence of secondary hemorrhage within one month after operation were not significantly different (P> 0.05). In group B, the duration of bladder flushing after operation and the amount of irrigation fluid consumed were significantly different from those in group A (P <0.01), and no significant difference was observed in other clinical observations (P> 0.05). Conclusions Patients with high PSA levels have more bleeding during TURP.