前列腺切除术后大出血的预防和处理

Prevention and management of severe post-prostatectomy hemorrhage

目的 :探讨前列腺切除术后大出血的原因和防治措施。方法 :回顾性分析 1973年 6月～ 2 0 0 2年 10月 4 82例前列腺切除术患者临床资料。结果 :2 1例术后发生大出血 ,其中 14例经保守治疗痊愈 ,6例经再次开放手术止血 ,1例电切镜止血。结论 :术中止血确切及术后保持引流通畅是预防前列腺切除术后大出血的关键 ,术后及时发现出血并正确处理可避免再次手术 ,对保守治疗失败者需再次手术治疗。

Objective:To study the cause,prevention and cure of severe post prostatectomy bleeding.Methods:The records of 482 cases hospitalized during June 1973 to October 2002 were reviewed and analyzed.Results:Severe post prostatectomy hemorrhage was found in 21 cases.Fourteen of them were treated with conservative method,6 by reexploration and 1 with endoscopic cautery techniques.Conclusions:Prevention of post prostatectomy hemorrhage depends on definite intraoperative hemostasis and postoperation care for the catheter patency.Early and proper management can avoid reexploration.Reexploraton is generally reserved for severe refractory cases.