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目的探讨前列腺切除术后继发性出血的高发时间、高危因素、处理方法及可能的原因。方法对1996年6月~2006年5月间我院608例前列腺切除术中22例发生继发性出血的临床资料进行回顾性分析。结果其中耻骨上前列腺切除术后继发性出血发生率高于经尿道前列腺切除术。出血时间为术后4~18 d不等,平均9.2 d。便秘、咳嗽、尿路感染和高血压等为高危因素。经留置导尿加膀胱冲洗、止血、预防感染、对症治疗及手术处理患者痊愈。结论前列腺切除术后继发性出血是前列腺切除术后常见并发症之一。加强围术期各种高危因素的积极处理是降低其发生率的关键。治疗包括留置导尿加膀胱冲洗、各种对症处理及手术。缝线吸收、焦痂或感染坏死物脱落等病理过程致小血管重新开放出血为其可能的病因。
Objective To investigate the high incidence of post-prostatectomy bleeding, risk factors, treatment methods and possible causes. Methods The clinical data of 22 cases of secondary hemorrhage in 608 cases of prostatectomy in our hospital from June 1996 to May 2006 were analyzed retrospectively. Results Among them, the incidence of secondary bleeding after suprapubic prostatectomy was higher than that of transurethral resection of prostate. The bleeding time ranged from 4 to 18 days after operation, with an average of 9.2 days. Constipation, cough, urinary tract infections and high blood pressure are risk factors. After indwelling catheterization plus bladder irrigation, bleeding, prevent infection, symptomatic treatment and surgical treatment of patients recovered. Conclusions Secondary hemorrhage after prostatectomy is one of the common complications after prostatectomy. To strengthen the perioperative management of various risk factors is to reduce the incidence of the key. Treatment includes indwelling catheterization plus bladder irrigation, a variety of symptomatic treatment and surgery. Suture absorption, eschar or necrosis shedding and other pathological processes caused by small blood vessels to reopen bleeding as its possible cause.