CAJ | 학술논문

目的：探讨前列腺术后出血致纤溶亢进的诊断与临床处理，探究前列腺术后出血致纤溶亢进的病因。方法将2006年10月至2013年10月我科收治的52例前列腺增生术后出血患者分为两组：纤溶亢进组和无纤溶亢进组，并对这两组的术前、术后的临床资料进行回顾分析。结果其中20例患者D-二聚体阳性或显著升高，凝血时间明显延长，纤维蛋白原降低，考虑继发性纤溶亢进。所有52例患者痊愈出院，无死亡及器官功能衰竭等严重并发症发生，前列腺术后无纤溶亢进组出血量为320mL（中位数），纤溶亢进组术后出血850mL（中位数），两者的差异具有统计学意义（P＜0.01）；术后住院时间无纤溶亢进组为（7.03±0.86）d，纤溶亢进组（7.40±0.75）d，两组间无明显差异（P＞0.05）。术后并发症及国际前列腺症状评分、生活质量评分及术后最大尿流率两组间无明显差异（P＞0.05）。结论前列腺术后出血致纤溶亢进若治疗及时得当，可使病情及早得到控制，术后效果和远期并发症均与无纤溶亢进患者无明显差异。大多数前列腺术后出血致纤溶亢进患者出血可通过非手术治疗方式治愈。
목적：탐토전렬선술후출혈치섬용항진적진단여림상처리，탐구전렬선술후출혈치섬용항진적병인。방법장2006년10월지2013년10월아과수치적52례전렬선증생술후출혈환자분위량조：섬용항진조화무섬용항진조，병대저량조적술전、술후적림상자료진행회고분석。결과기중20례환자D-이취체양성혹현저승고，응혈시간명현연장，섬유단백원강저，고필계발성섬용항진。소유52례환자전유출원，무사망급기관공능쇠갈등엄중병발증발생，전렬선술후무섬용항진조출혈량위320mL（중위수），섬용항진조술후출혈850mL（중위수），량자적차이구유통계학의의（P＜0.01）；술후주원시간무섬용항진조위（7.03±0.86）d，섬용항진조（7.40±0.75）d，량조간무명현차이（P＞0.05）。술후병발증급국제전렬선증상평분、생활질량평분급술후최대뇨류솔량조간무명현차이（P＞0.05）。결론전렬선술후출혈치섬용항진약치료급시득당，가사병정급조득도공제，술후효과화원기병발증균여무섬용항진환자무명현차이。대다수전렬선술후출혈치섬용항진환자출혈가통과비수술치료방식치유。
Objectives To explore the diagnosis, clinical treatment and etiology of postoperative bleeding-caused fibrinolytic hyperfunction in 20 patients with prostate hyperplasia. Methods Clinical data of 52 BPH patients with postoperative bleeding were retrospectively analyzed. All the patients were divided into two group such as fibrinolytic hyperfunction group and non fibrinolytic hyperfunction group. Results Among 52 patients, 20 had high level of D-dimmer, the clotting time prolonging and low level of fibrinogen. They were diagnosed as fibrinolytic hyperthyroidism. All the 52 patients were cured, and no death and serious complications such as organ failure were found. There was significant difference in postoperative bleeding amount between fibrinolytic hyperfunction group and non fibrinolytic hyperfunction group (P<0.01). There was no significant difference in day of hospital stay[(7.03±0.86)d and (7.40±0.75)d, P>0.05], and no significant differences in postoperative complications and international prostate symptom score, quality of life score and Qmax between these two groups (P>0.05). Conclusion The early and proper treatment is helpful to control the condition. There are no significant differences in postoperative effect and long-term complications between two groups. Most patients with fibrinolytic hyperthyroidism can be cured by non-surgical methods.