耻骨上前列腺切除术止血问题探讨——附75例报告

Study of hemostasis problem for suprapubic prostatectomy——75 ca ses of report

[目的 ]探讨耻骨上前列腺切除术的止血问题 .[方法 ]对 73例前列腺增生症和 2例前列腺癌病人施行了耻骨上前列腺切除术 ,采用术前静脉注射立止血、术中肾上腺纱布填塞前列腺窝、前列腺窝边放置浸泡有凝血酶的明胶海绵的同时气囊压迫前列腺窝等系列止血方法 .[结果 ]本组 75例术后冲洗液转清时间为 12～ 48h ,平均 2 3h ,其中 ,12h内 2 4例 ,2 4h内 6 0例 ,36h内 73例 ,48h内 75例 .术后无一例发生立止血及肾上腺素的副作用 ,并且未发生明胶海绵块堵塞尿道内口 ,止血效果明显 .[结论 ]立止血、肾上腺素、凝血酶及明胶海绵联合应用在耻骨上前列腺切除术中是一种有效的止血方法 .

OBJECTIVETo study the hemostasis proble m on suprapubic prostatectomy.METHODS73 cases of prostatic hyp erplasia and 2 cases of prostatic cancer were treated by suprapubic prostatectom y.In preoperation, intravenous injection the Reptilase was adopted. In the o pe ration, the prostatic fossa was packed with the gauze of adrenalin. the bladder neck wedge was sutured with a chromic catgut to control bleeding. The prost atic fossa side was placed with Spongia Getatini Absorbens soaked with thromba se and Foley ballon inflated with sterile water was placed in the prostatic fossa to compress hemostasis.RESULTSOf 75 cases of operation, the time of beginning to clear of the urine was 12～48 h, average 23 h, 12 h in 24 c ases, 24 h in 60 cases, 36 h in 73 cases and 48 h in 75 cases. There was no one c ase side effect of the reptilase and adrenalin and the Spongia Getatini Abs orben s obstruction urethral internal meatus.CONCLUSIONReptilase, adrenalin, thrombase and Spongia Getatini Absorbens combined application o n suprapubic prostatectomy are very effective hemostasis method.