前列腺切除术后继发性出血22例分析  

Analysis of post-prostatectomy hemorrhage:report of 22 cases

作　　者：杨凌峰[1] 蒋悦[1] 张宝金[1] 陈挺[1] 楼坚[1] 林连祥[1] 郑祥毅[2] 

机构地区：[1]浙江省丽水市中心医院泌尿外科,丽水323000 [2]浙江大学医学院附属第一医院泌尿外科

出　　处：《临床医学》2007年第8期1-2,共2页Clinical Medicine

摘　　要：目的探讨前列腺切除术后继发性出血的高发时间、高危因素、处理方法及可能的原因。方法对1996年6月-2006年5月间我院608例前列腺切除术中22例发生继发性出血的临床资料进行回顾性分析。结果其中耻骨上前列腺切除术后继发性出血发生率高于经尿道前列腺切除术。出血时间为术后4-18 d不等,平均9.2 d。便秘、咳嗽、尿路感染和高血压等为高危因素。经留置导尿加膀胱冲洗、止血、预防感染、对症治疗及手术处理患者痊愈。结论前列腺切除术后继发性出血是前列腺切除术后常见并发症之一。加强围术期各种高危因素的积极处理是降低其发生率的关键。治疗包括留置导尿加膀胱冲洗、各种对症处理及手术。缝线吸收、焦痂或感染坏死物脱落等病理过程致小血管重新开放出血为其可能的病因。Objective To explore high incidence time,high risk factors,treatment and causes of post - prostatectomy hemor- rhage. Methods From June 1996 to May 2006, there were 608 patients underwent prostatectomy, of which 22 patients had post - prostatcetomy hemorrhage. The clinical data of which were analysed retrospeetivel. Results The incidences of post - prostatecto- my hemorrhage of transurethral prostatectomy were higher than suprapubie prostatectomy. The time of hemorrhage was 4 - 18 days post -operatively, average time was 9. 2 days. Astriction, cough, urinary tract infection and hypertension were the risk factors. The treatments included indwelling catheter and washing bladder, hemostalsis, preventing infection and re - operation. Conclusion Post -prostatectomy hemorrhage was a common complication of prostateetomy. Actively seized of the various risk factors during perioperative period were the key for reducing its incidences. The treatments involved washing bladder after indwelling catheter, various therapies to control symptoms and re - operation. Re - open of small vessel due to stitch absorption and defluvium of in- flammatory necrosis may be the main causes.

关 键 词：前列腺切除术 继发性出血 

分 类 号：R699.8[医药卫生—泌尿科学]