前列腺增生经尿道电切术后早期出血再手术原因分析

目的探讨前列腺增生经尿道电切术后早期出血再手术的原因及其防治方法。方法回顾分析采用经尿道前列腺电切术治疗前列腺增生866例中术后48h内早期出血再手术者46例资料。结果前列腺包膜穿孔、静脉窦开放出血22例，膀胱颈口出血7例，三角区黏膜或肌层损伤出血6例，膀胱壁造瘘口出血5例，凝血功能障碍前列腺窝渗血4例，组织碎块堵塞2例。再次手术后均止血成功，无并发症。结论经尿道前列腺电切术围手术期及术中各个阶段处理不当均可造成不可控制的出血。熟练的操作技术，止血彻底，避免切穿前列腺外科包膜可减少术后出血再手术。

Analysis of the reasons of re-surgery for early bleeding after TURP

Objective To explore the reasons and the prophylactic measures of re-surgery for hemorrhage after TURP in the treatment of benign prostatic hyperplasia. Methods The data of 866 cases with BPH underwent transurethral resection,prostate were analyzed retrospectively, 46 cases need re-sugery for early bleeding within 48hours after TURP. Results Prostactic capsule perforation and venous sinus bleeding were occurred in 22 cases; bladder neck oriffice bleeding was occurred in 7cases; membrane and muscular layer lesion in the triangle reagion was occurred in 6cases; bleeding in cystostomic bladder wall was occurred in 5 cases; Prostactic fossa staxis due to coagulatory dysfunction was occurred in 4 cases; tissue fragment obstruction was occurred in 2 cases. Bleeding was controlled after re-surgery in all cases without complications. Conclusions Mismanagements during perioperative period of TURP can lead to bleeding Proficient skills and handling bleeding completely in each step and paying more consideration for avoiding cutting through prostate surgical capsule may reduce post-operative bleeding that needs re-surgery.