Diagnosis And Analysis Of Transurethral Prostatic Plasma Cutting Postoperative Bleeding

Objective:Benign Prostatic Hyperplasia(BPH) is a common age-related disease. Analyze and summarize bipolar transurethral resection of plasma(TUPKP) treatment of benign prostatic hyperplasia postoperative bleeding causes and prevention methods. Evaluation of transurethral resection of the plasma treatment of benign prostatic hyperplasia efficacy and safety of surgery, Choose the best surgical approach and treatment options for urological minimally invasive treatment of benign prostatic hyperplasia patients. Methods:A retrospective analysis of the period from June 2006 to November 2013 plasma treatment transurethral resection of benign prostatic hyperplasia surgery 850 cases, All patients had typical symptoms associated with benign prostatic hyperplasia, is not proportional to the volume of their symptoms and benign prostatic hyperplasia, Ancillary tests such as ultrasound, urodynamic and Dre, etc., after all histopathological examination confirmed both benign prostatic hyperplasia. BPH patients postoperative bleeding 30 patients aged 55-78 years, mean age 65.8 years, duration of 1-5 years, an average of 2.6 years. The clinical data transurethral resection of the plasma of patients with bleeding, analyze and summarize the causes of bleeding in patients, treatment and prevention methods. Grouped according to the number of bleeding, the, Determination Application bleeding MACRO sperm counter observations. In the rinse solution 30 ml / h containing blood as the standard, wherein the control amount is less than a standard amount of bleeding conservative treatment, the amount of bleeding was observed in the group using the standard amount for return to the operating room, the treatment effects were observed and hemostasis. Results:Bleeding causes include patients with preoperative, intraoperative and postoperative 3 factors, 30 cases by according to the different condition take a conservative or surgical treatment, and patients were bleeding success, rehabilitation hospital discharge. 20 cases of conservative treatment, 10 cases were bleeding speed, bladder filling, and line into the operating room under the electricity cut mirror clean blood clots, According to the calculation result in the case of postoperative bleeding group, the control group in which a small amount of bleeding, pale red solution was washed in 20 cases, the application MACRO calculated volume of blood loss <30ml / h, aged 46-57 years, mean age(56.5 ± 8.3) years; weighing 48-65 kg, the average weight(53.57 ± 6.43) kg, duration of 1-4 years, the average duration(1.56 ± 1.03), the bleeding time after 2-4h in 10 cases, 7d after the 6 cases, within 3 months after four cases. Observation group large amount of bleeding, bright red fluid in 10 cases, the application of MACRO calculated blood loss volume> 30 ml / h, aged 55-78 years, mean age(67.6 ± 8.4) years; weighing 57-76 kg, the average weight(64.36 ± 6.59) kg, duration of 1-5 years, the average duration(2.62 ± 1.06) years, postoperative bleeding time 2-4h 7 cases, 2 cases of postoperative 7d, within 3 months after one case. Hematuria with the general principles of treatment, such as the need to give the operating room cystoscopy or coagulation, focusing on treatment-induced bleeding after transurethral resection of the prostate prevention and treatment of the primary disease and bleeding causes.After a comprehensive analysis of postoperative bleeding due to:(1) preoperative underlying diseases(such as coronary heart disease 10 cases, 9 cases of diabetes, urinary tract infection 10 cases, 13 cases of hypertension, chronic bronchitis and emphysema 5 cases and all causes of thrombin and prolonged bleeding tendency original).(2) is not complete resection of the prostate surgery, excessive residual prostate tissue, prostate fossa after infection, trauma surgery prostate capsule, hemostasis and so on.(3) after excessive activity, pain and increased abdominal pressure, improper force, constipation and other factors, such as stress caused by postoperative coagulation dysfunction. Conclusion:Transurethral resection of the prostate plasma causes of bleeding and hemostasis comparison and evaluation, preoperative, intraoperative and postoperative bleeding timely and accurate processing is a very critical factor in reducing the basic performance of three categories:(1) preoperative prepare a hurry is not sufficient,(2), intraoperative surgical operation due to specification or unskilled person to grasp the extent of surgery,(3), were observed after treatment is not timely. Perfect the necessary preoperative examination, surgical indications must be strictly; intraoperative standard operation, the surgeon must be able to master the surgical operation to fine Fu as a symbol, removal of the prostate to the outside of the envelope, excision wound formation, bleeding completely; Timely observation of postoperative symptomatic treatment, antibiotics to prevent infection, good guidance of the patient. Mild bleeding can be treated conservatively, given the speed increase bladder irrigation to keep the drainage tube patency, oral capsules and other hemostatic drugs such as Yunnan Baiyao, treatment of the underlying disease or primary disease; severe bleeding bleeding can be given intravenous drugs such as blood clotting enzyme etc., make up the volume and rapid bladder irrigation, etc., such as blood clots occur when blood clots timely removal of bladder filling, there is significant bleeding were given surgical electrocautery to stop bleeding, bleeding after the patient had no significant reposition the catheter to keep the bladder rinse and drain open.