Nursing after transurethral resection of the prostate
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The prostate is the male sex gland organ, a sex gland with both internal and external secretory functions. Due to improper care for many reasons, the prostate will show symptoms of different diseases at different ages, such as prostate hypertrophy, prostate hyperplasia, bacterial infection, chronic prostatitis, etc. Some people will choose transurethral resection of the prostate when their condition becomes serious. Postoperative treatment 1. Prevention and treatment of shock During and after surgery, the circulating blood volume should be supplemented appropriately, hyponatremia should be corrected, and the occurrence of shock should be prevented and treated according to the patient's blood loss, blood pressure and hemoglobin changes. 2. Keep the drainage of the catheter unobstructed and closely observe the color of the drained urine. The catheter should be flushed regularly within 24 hours after the operation to flush out or aspirate out small blood clots in the bladder. If there is no active bleeding, the air balloon will be deflated and the catheter will be removed on the third day. 3. After surgery, water and electrolyte balance should be strengthened and drinking water should be encouraged. 4. Prevention and treatment of infection: For patients with pre-operative urinary tract infection, effective antibiotics should be given in time, and surgery should be performed only after the infection is controlled. Otherwise the infection can spread throughout the body, causing bacteremia and sepsis. Broad-spectrum antibiotics should also be used after surgery to control infection. 5. Prevention and treatment of urethral stenosis and urinary incontinence The artery of the electrosurgical resectoscope should be operated gently and carefully, and the cutting range must be accurate and reliable. If too much mucosa is removed at the junction of the prostatic and membranous parts of the urethra, the external urethral sphincter may be damaged, resulting in postoperative urinary incontinence, which should be avoided as much as possible. If urethral stenosis or bladder neck contracture stenosis occurs, urethral dilation should be performed regularly. 6. Bleeding occurs if the urine is bright red after the operation, there is a blood clot blocking the urinary tract, the blood pressure drops, and blood transfusion is ineffective. If necessary, you need to go back to the operating room to stop the bleeding. Secondary bleeding usually occurs about 10 days after surgery, and is caused by the shedding of necrotic material caused by infection. The treatment method is to insert a balloon catheter into the urethra, inject 20 to 30 ml of air into the balloon, compress the bladder neck, and flush the bladder with saline until all blood clots are removed and the returned water is light red. At the same time, add 800 mg of 6-aminocaproic acid into 1000 ml of normal saline for bladder irrigation and intravenous rehydration, and add 0.4 g of tranexamic acid to every 1000 ml of rehydration. Generally, good results can be achieved. |
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