经尿道前列腺电切术后近期出血的原因及治疗（附69例报告）  

Reason and Treatment of Recent Hemorrhage after Transurethral Resection of Prostate：a report of 69 cases

作　　者：范海涛[1] 张明[1] 国贺[2] 

机构地区：[1]吉林大学第二医院泌尿外科,吉林长春130041 [2]吉林大学中日联谊医院放疗科,吉林长春130033

出　　处：《医学临床研究》2009年第4期620-622,共3页Journal of Clinical Research

摘　　要：【目的】探讨经尿道前列腺电切术（TURP）术后近期出血的原因及治疗。【方法12000年6月至2007年12月，吉林大学第二医院泌尿外科与吉林大学中日联谊医院共进行TuRP2000例，其中69例术后发生近期出血。根据具体情况，给予保守治疗、经尿道电凝止血及开放手术止血等。【结果】经处理后所有病人均止血。36例经应用止血药物、牵拉三腔气囊尿管压迫膀胱颈止血、加快膀胱冲洗及抽吸血块、镇静、解痉、补液、输血等保守治疗方法处理后好转。29例经保守治疗处理无效，麻醉后重新置入电切镜，用Ellik冲洗出血凝块，寻找出血点，电凝止血后留置F22三腔气囊尿管；4例行开放手术止血。全部病例未发生再次出血。术后5～8d拔除尿管，均排尿通畅。6例出现短暂尿失禁，经盆底功能锻炼后好转。4例尿道狭窄，经定期尿道扩张后治愈。随访3～24个月，平均9个月，无尿失禁、再次出血等。【结论】对于前列腺增生行TURP术后病人，一旦发生术后近期出血，则应先明确原因，给予保守治疗，如果保守治疗无效，则应果断地进行电凝止血或开放手术。只要及时正确地诊断与处理，病人均有良好的预后。[Objective] To investigate the reason and treatment of recent hemorrhage after transurethral resection of prostate（TURP）. [Methods] A total of 2000 cases of benign prostate hyperplasis（BPH） were treated with TURP from June 2000 to December 2007. Sixty nine cases had recent hemorrhage. Expectant treatment, transurethral electric coagulation or open surgical hemostasis was adopted. [Results] All the cases stopped bleeding. Thirty six cases underwent expectant treatment. Twenty nine cases underwent transurethral electric coagulation. Open operations were done in 4 cases. All the cases pissed well. Incontinence of urine happened in 6 cases and disappeared soon. Stricture happened in 4 cases which were cured by dilation of ure thra. The follow up time was 3 to 24 months. There was no case of incontinence of urine and another hemor rhage. [Conclusion] If recent hemorrhage happens after TURP, the reason must be found. Expectant treat- ment is the first choice. Transurethral electric coagulation or open operations should be done in case of emer gency. All the cases have good prognosis after prompt exact diagnosis and treatment.

关 键 词：电外科手术 前列腺切除术 出血/病因学 

分 类 号：R697.32[医药卫生—泌尿科学] R163[医药卫生—外科学]