经尿道前列腺电切术后出血的原因及防治.docxVIP

经尿道前列腺电切术后出血的原因及防治 王长春 (重庆市铜梁区人民医院泌尿外科402560) 【摘要】目的：探讨经尿道前列腺等离子电切术(TURP)后出血的原因及 防治措施。方法：回顾性分析2008年6月?2015年6月在我院行TURP术的766 例良性前列腺增生症(BPH)患者的临床资料，其中35例发生了术后岀血。结 果：出血原因主要有患者自身基础疾病因素、手术因素、术后过早或过度活动、 术后膀胱痉挛及导尿管因素等。其中静脉出血28例，小动脉出血7例。35例中 26例经保守治疗而好转，9例再次行电切镜下止血，其中8例止血效果满意，有 1例止血效果不佳，改为开放手术止血而死亡。结论：TURP术后出血是常见并 发症，其原因是多方面的，充分的术前准备，术中止血彻底，术后早期发现并及 时处理，可以减少或有效治疗TURP术后出血。 【关键词】良性前列腺增生症；经尿道前列腺电切术；术后出血 【中图分类号】R619 【文献标识码】A 【文章编号】2095-1752 (2015) 28-0150-02 Analyse the causes and prevention of hemorrhage after transurethral resection of prostate Wang changchun. Department of Urology, The People’s Republic Hospital of Tongliang, Chongqing 402560, China [Abstract] Objective To investigate the causes and prevention of hemorrhage after transurethral resection of the prostate(TURP)- Methods A retrospective analysis was carried out in 766 cases, who were by TURP in our hospital during Jun 2008 to Jun 2015. Among the cases, 35 patients developed hemorrhage after the operation. Results The causes were varied,such as operation correlative factor,excessive exercise and cystospasm after the operation, the urinary catheter related factors」n the 35 cases. 28 cases were venous hemorrhage and 9 cases were small artery hemorrhage .26 cases were successful by conservative treatment, such as increasing the douche speed and the tractio n inten sity ? 9 cases were accepted the sec on dary hemostasis under cystoscop, and lease died of excessive loss of blood.Conclusions Hemorrhage is a comm on complicati on after TURP operation- The occurre nee of this complication is closely related to many factors. The sufficient preoperative preparation ,hemostasis thoroughly in the operation ,timely detection and expansion treatment could significantly reduce the bleeding volume. 【Key words] Benign prostatic hyperplasia； Transurethral resection of the prostate； Postoperative hemorrhage 良性前列腺增生症(BPH)是泌尿外科老年男性患者的一种常见病、多发病， 经尿道前列腺电切术(TURP)是治疗BPH的“金标准”⑴，在广大基层医院也 已成为首选的手术方法。术后出血是其常见的并发症，严重吋其至危及患者生命, 因此积极防治TURP术后出血尤