経尿道的前立腺切除術直後のトロンビン溶液前立腺床内注入法に関する研究

Abstract

The effect of local administration of thrombin via a newly devised four-way balloon indwelling catheter was investigated on 89 patients who underwent transurethral resection of the prostate (TURP). The catheter was introduced into the bladder immediately after TURP, the balloon was inflated with sterile water and mild moist sponge traction was applied to seal the bladder neck for 15 minutes. At the same time, the thrombin solution, 5, 000 U in 5 ml of saline, was then injected into the prostatic fossa via the newly added infusion channel to promote early hemostasis. The results were compared with those of 36 randomized control patients, who were treated with the conventional three-way balloon catheter of the same size. The results obtained with this new device were favorable, showing significantly less postoperative hemorrhage in the thrombin infusion group than in the control group. In 7 of 89 thrombin infused patients, serum FDP revealed mild elevation for 2 hours after TURP. In 2 of these 7 patients FDP was closely correlated with thrombin infusion. However, no adverse reactions were observed in any patient in the thrombin infusion group. In conclusion, our new device to administer locally the thrombin solution is effective and safe for management of bleeding after TURP.