前列腺汽化电切术后大出血的预防与处理  

Prophylaxis and management of severe postoperative hemorrhage of transurethral vaporization resection of prostate

作　　者：汪金荣[1] 蒋先镇[1] 郭军华[1] 陈菁菁[1] 

机构地区：[1]中南大学湘雅三医院泌尿外科,湖南长沙410013

出　　处：《中国内镜杂志》2005年第5期528-530,532,共4页China Journal of Endoscopy

摘　　要：目的探讨经尿道前列腺汽化电切术(TUVP)后大出血的预防与处理。方法对TUVP术后大出血患者行保守治疗、电切镜下止血或手术止血。结果310例行TUVP术患者中,12例发生术后大出血,出血发生于术后1￣25d,多发生于2、3周。经保守治疗止血6例,经电切镜止血5例,经开放手术止血1例。结论术前充分做好准备,术中止血确切,术后保持引流通畅,避免创面感染及受压是预防TUVP术后大出血的关键。及时发现并处理前列腺术后出血,多可行保守治疗,避免再次手术。电切镜下止血是一种安全而有效的治疗方法,术后出血较多,经保守治疗及电切镜下止血无效时应及时转开放手术。Objective] To discuss the preventive methods and management of severe postoperative hemorrhage of transurethral vaporization resection of the prostate. [Methods] The patients with severe postoperative hemorrhage received hemostasis by conservative treatment, endoscopic cautery or reoperation. [Results] TUVP was undertaken for 310 patients with benign prostatic hyperplasia and 12 cases had severe postoperative hemorrhage, bleeding occured in 1~25 days following operation, most occurred in 2, 3 weeks. among the 12 patients 6 received conservative treatment, 5 received hemostasis by endoscopic cautery and 1 received open operation. [Conclusions] Sufficient preparation of preoperative, definite hemostasis of intraoperative, keeping catheter patency avoiding the infection and squeezing the wound of prostate is important to decline the complication of severe postoperative hemorrhage. discovered early and managed promptly, most patients can stop bleeding without reoperation, endoscopic techniques offers a safe and efficient method of hemostasis. For some severe cases, when conservative treatment and endoscopic cautery is invalid, reoperation should be performed in time .

关 键 词：前列腺汽化电切术 出血 

分 类 号：R697.32[医药卫生—泌尿科学]