经尿道切除高龄重度前列腺增生术后并发严重尿脓毒症2例报告并文献复习  

Transurethral resection of severe prostate hyperplasia in elderly patients and its postoperative severe urosepsis complication： report of 2 cases and review of literature

作　　者：王晓东 黄永斌[2] 张海涛[2] 刘兆飞[2] 聂锐志 刘希珍[2] 林则馨[2] 

机构地区：[1]解放军第149医院泌尿外科,连云港222000 [2]连云港市中医院泌尿外科

出　　处：《中国男科学杂志》2012年第2期29-32,共4页Chinese Journal of Andrology

摘　　要：目的结合文献探讨2例经尿道等离子体前列腺切除（PKRP）高龄重度前列腺增生（BPH）术后发生严重尿脓毒症患者的诊疗体会。方法2例年龄超过80岁的BPH患者，PKRP后发生严重尿脓毒症。分析严重尿脓毒症发生与术前有无尿路感染、膀胱结石、手术时间、术中出血量等之间的关系和预防治疗方法。结果术前有尿路感染以及合并膀胱结石、手术时间长、术中出血量大者，可能是术后严重尿脓毒症的发病原因。术前控制感染，术后早期诊断，积极复苏和正确使用抗生素等是治疗严重尿脓毒症的关键。结论对于PKRP高龄重度BPH患者，要根据老年人的生理特点，术前准备充分，术中尽量缩短时间、减少出血，术后早期诊断和积极处理，这是预防和治疗高龄PKRP后严重尿脓毒症的有效措施。Objective To discuss the diagnosis and treatment of severe urosepsis complication in two elderly patients with severe benign prostatic hyperplasia treated with transurethral resection. Methods Two patients, aged over 80, with benign prostatic hyperplasia were treated with transurethral plasmakinetic resection of prostate hyperplasia. They had severe urosepsis complication after operation. The relationship between occurrence of severe urosepsis and preoperative urinary tract infection, bladder stones, operation time, bleeding volume, and the methods of prevention and treatment were analyzed. Results Preoperative urinary tract infection and bladder stones complicated with long operation time, big intraoperative bleeding amount might be the cause of postoperative severe urosepsis. Preoperative control infection, postoperative early diagnosis, aggressive resuscitation and correct use of antibiotics were the key points for treatment of severe urosepsis. Conclusion For aged patients with severe prostate hyperplasia treated with transurethral resection, it is important to prevent severe urosepsis complicaton with some effective measure ,such as caring about the physiological characteristics of the elderly, preoperative preparation, shortening the intraoperative time, reducing bleeding, early postoperative diagnosis and aggressive treatment..

关 键 词：经尿道前列腺切除术 脓毒症 

分 类 号：R697.32[医药卫生—泌尿科学]