摘要
目的分析高危前列腺增生患者经尿道前列腺电汽化术术中、术后早期并发症的原因并提出防治对策。方法回顾分析647例高危前列腺增生患者围手术期处理方法及术中、术后早期并发症发生率,并探讨两者关系。结果647例手术平均时间(48±32)min,切除腺体重量(42.1±12.6)g。术中、术后早期总并发症发生率12.4%,术中并发大出血3例(0.5%),电切综合征6例(0.9%),尿道膀胱损伤3例(0.5%),包膜穿孔4例(0.6%),冲洗液外渗行剖腹探查引流术3例(0.5%);术后早期并发症:大出血14例(2.2%),其中经尿道再手术止血7例(1.1%),输血7例(1.1%),弥漫性血管内凝血2例(0.3%),下肢深静脉血栓形成1例(0.2%),暂时性尿失禁12例(1.9%),拔管后不能排尿再次留置尿管35例(5.4%)。结论高危前列腺增生患者要降低术中术后并发症的发生率,应重视手术技巧,缩短手术时间,提高对并存疾病危险性的认识,重视围手术期个体化处理,及时防治术中、术后早期并发症。
Objective To analyse reasons and provide countermeasures of the early postoperative complications during and after transurethral vapor - resection of prostate （TVP） in high - risk BPH patients. Methods To analyse the treatment of 647 cases of high - risk BPH patients in perioperative periods and the incidence of intraoperative or early postoperative complications retrospectively. To explore the relationship between them. Results In the 647 cases of surgery ,the average time was （48 ± 32）mins, the weight of removal gland was （42.1 ± 12.6 ）g. The total incidence of intraoperative or early postoperative complications was 12.4% ,the intraoperative bleeding complication was found in 3 cases （0.5%） ,TURP syndrome （TURS） in 6 cases （0.9%） ,urethral or bladder injury in 3 cases （0.5%） ,membrane perforation in 4 cases （0.6%） ,extravasation of fluid needing drainage from laparotomy in 3 cases （0.5%） ;The early postoperative complications： 14 cases of mass bleeding （2.2%） ,in which 7 cases needing transurethral re -operation to stop bleeding （ 1.1% ）, the other 7 cases needing blood transfusion （ 1.1% ）. Disseminated intravascular coagnlation （DIC） was fofind in 2 cases （0.3%） ,deep venous thrombosis in 1 case （0.2%） ,transient urinary incontinence in 12 eases （1.9%）, and indwelling urinary catheter again after extubation in 35 cases （5.4%）. Conclusions To reduce the incidence of postoperative complications in high - risk BPH patients, one should pay attention to surgical technique, shorten the time of operation, raise awareness of dangers of the comorbidity, pay attention to individual perioperative treatment, and prevent early postoperative complications timely.
出处
《医学信息（内.外科版）》
2009年第9期783-785,787,共4页
Medical Information Operations Sciences Fascicule
关键词
前列腺增生
经尿道前列腺电汽化术
并发症
benign prostatic hyperplasia
transurethral vapor - resection of prostate
complications
