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目的探讨经尿道前列腺电切术后远期出血原因、诊疗方法及预防措施。方法回顾我院2000—2011年共发生20例经尿道前列腺电切术后远期出血患者的临床资料,10例予以保留导尿,膀胱冲洗,6例予以电切镜下膀胱冲洗止血治疗,1例膀胱切开血凝块清除术,3例抗感染治疗。19例治愈,1例再次出血,予电切镜止血。结果总结分析远期出血的好发时间为术后1～4周;主要原因是患者自身因素(高血压病、糖尿病、冠心病、脑血管病应用抗凝药物、COPD)及久坐、大便干燥、慢性咳嗽、剧烈活动、坐浴、电切创面焦痂脱落、前列腺电切创面感染等;治疗上对膀胱内充满凝血块不能冲洗吸出者电切镜下清理凝血块及止血是一种安全有效的方法。结论全面的术前分析和采取预防措施、准确的术中和术后处理及详细的出院指导和抗生素应用是预防BPH患者TURP术后远期出血的关键,术后及时发现出血并正确处理可避免再次手术。
Objective To investigate the causes, diagnosis and treatment of long-term hemorrhage after transurethral resection of prostate and preventive measures. Methods The clinical data of 20 patients with long-term hemorrhage after transurethral resection of prostate in our hospital from 2000 to 2011 were retrospectively reviewed. Ten patients were given catheterization and bladder irrigation. Six patients underwent resection of the bladder with hemostasis Cases of cystoidectomy, 3 cases of anti-infection treatment. 19 cases were cured, 1 case of bleeding again, to resectoscope to stop bleeding. Results Summary Analysis of long-term hemorrhage occurred in 1 to 4 weeks after surgery; the main reason is the patient’s own factors (hypertension, diabetes, coronary heart disease, cerebrovascular disease with anticoagulant drugs, COPD) and sedentary, dry stool , Chronic cough, strenuous activity, bathing, electric cutting wound eschar, electric prostatectomy wound infection; treatment of the bladder filled with clot can not be washed aspiration of patients undergoing resectoscope coagulation clot and stop bleeding is a safe and effective Methods. Conclusion Comprehensive preoperative analysis and preventive measures, accurate intraoperative and postoperative management and detailed discharge guidance and antibiotic application are the key to prevent long-term hemorrhage after TURP in patients with BPH. Bleeding and correct treatment can be avoided after operation Reoperation.