前列腺增生症术后继发出血的临床分析

Clinical analysis of secondary bleeding after prostatectomy

目的探讨前列腺增生术后继发出血的原因及治疗方法。方法对524例有手术指征的前列腺增生病人行手术治疗。术后观察1-4周,并对19例继发出血病例进行治疗。结果1周内继发出血病例7例:尿管气囊脱入前列腺残窝4例,并发纤溶系统亢进2例,前列腺残窝出血1例。需再手术5例。2-4周内出血12例:前列腺残窝炎9例,前列腺组织残留部出血3例。需再手术5例。结论前列腺术后再出血原因早期主要是尿管滑脱导致膀胱颈部撕裂以及纤溶系统亢进,后期主要是前列腺残窝炎和前列腺组织残留,膀胱血块填塞以及前列腺组织残留出血应及时手术处理。

Ojective To study the reason and treatment of secondary bleeding after prostatectomy. Methods A total of 524 subjects were operated,and observed for 1-4 weeks after operation. 19 cases of secondary bleeding were treated. Results 7 cases were bled secondarily, This included ballon catheter slipping into prostatic cavity (4),Fibrin dissolusion system hypertasion(2),Prostatic cavity bleeding(1).12 patients bled secondarily in 2-4 weeks,This included prostatic cavity infection(9),Prostatic remains bleeding(3).5 patients were operated secondarily. Conclusions The early main reason of secondary bleeding after prostatectomy is that bladder neck was tear to pieces by ballon catheter slipping and fibrin dissolution system hypertension. The later main reason is that prostatic cavity infection and prstate remain.