摘要
目的：探讨经尿道等离子体双极前列腺电切术（transurethral plasmakinetic resection of prostate,PKRP）后早期出血致膀胱填塞的原因。方法回顾分析我院2005年1月—2012年1月35例 PKRP 术后24 h 内出血致膀胱填塞患者的临床资料。结果本组常规行 PKRP,术中均顺利,膀胱填塞发生于术后6 h 内28例,6~12 h 内7例。19例表现为下腹部剧痛,冲洗液鲜红或伴随冲洗液反流；16例无主诉,仅表现为冲洗液反流或停止或波动样流动。35例经 B 超检查明确膀胱填塞,重返手术室酌情采取镜下冲洗血凝块、电凝止血,或电切血凝块,或电切残留小腺体并电凝止血等处理,5 d 后出院。随访2~7年,排尿正常,无再次出血。结论膀胱痉挛是 PKRP 术后24 h 内出血致膀胱填塞的高危因素,尤其对下腹部无明显疼痛的膀胱痉挛患者,要善于观察,并及早行 B 超检查,避免延误诊断与处理。
Objective To explore the causes of bladder tamponade induced by early bleeding after transurethral plas-makinetic resection of prostate （PKRP）. Methods Clinical data of 35 patients with bladder tamponade induced by early bleeding within 24 h after PKRP during January 2005 and January 2012 was retrospectively analyzed. Results All the pa-tients underwent routine PKRP of successful operation process, 28 patients had bladder tamponade within 6 h after the opera-tion, and 7 patients had bladder tamponade within 6 - 12 h after the operation, 19 patients suffered severe pain in lower abdo-men, bright red washing fluid or contraflow with washing fluid; 16 patients did not complain with contraflow, stopping or wave-like movement of washing fluid. All the 35 patients were confirmed with having the bladder tamponade by B ultrasound exami-nation, and underwent washing the blood clot under the microscope, electric coagulation hemostasis, transurethral clot or tran-surethral residual small glands electric coagulation treatment accordingly, and then were discharged 5 d after the treatment. No one patient had bleeding with normosthenuria with 2 - 7 years of follow-up. Conclusion Cystospasm is the high risk factor of bladder tamponade induced by early bleeding within 24 h after transurethral plasmakinetic resection of prostate, so clinicians should pay more attention especially to patients without obvious abdomen pain of cystospasm, and perform the B-mode ultra-sonography to avoid delay in diagnosis and treatment.
出处
《临床误诊误治》
2014年第7期93-95,共3页
Clinical Misdiagnosis & Mistherapy
关键词
经尿道前列腺切除术
并发症
膀胱疾病
原因分析
Transurethral resection of prostate
Complication
Bladder disease
Cause analysis
