经尿道前列腺电切术后出血原因分析及处理

目的 探讨经尿道前列腺电切术（TURP）后出血的原因及处理方法。方法 回顾性分析546例前列腺增生症（BPH）患者行TURP术，16例术后出血临床资料。结果 16例TURP术后出血的患者中：10例出血时期集中在术后48h内，6例集中在术后7—9d，前者主要原因有术中切割不彻底、止血不彻底、切穿前列腺包膜损伤静脉窦、穿刺时损伤膀胱前壁血管等，后者则系创面感染，焦痂脱落，腹压增加等。经积极处理患者均痊愈出院。结论 TuRP术后出血的原因主要与术中操作及术后创面感染，腹压增加等有关。只要医生能做到术中精细操作．术后加强抗感染及对症处理是防治TURP术后出血的关键。

Cause and Treatment on Postoperative Bleeding of Transurethral Resection of Prostate

Objective To explore the cause and treatment of postoperative bleeding of transurethral resection of the prostate(TURP).Methods From July 2001 to February 2005,546 patients with BPH were performed by TURP in the hospital,the clinical documents of 16 cases occurring postoperatine bleeding were reviewed and analysed.Results Among 16 cases of postoperatine bleeding,the bleeding period of 10 cases was within 48 hours,and that of 6 cases ranged from postoperative 7 to 9 days.The former causes mainly were incomplete incision and hemostasia, perforation of the capsule of prostate and cutting of the venous plexus,the injury of prevesical vessel during cutaneous vesicostomy.The latter resulted from inflammation of residual prostate tissues,eschar desquamation and increased abdominal pressure.All patients were cured after effective treatment.Conclusion Postoperative bleeding for TURP mainly caused by operative manipulation,inflammation of residual prostate tissues,and increased abdominal pressure.The proficient operation and positive antibiotic treatment is the key point to prevent postoperative bleeding.