经尿道前列腺电汽化术所致电切综合征的特点及防治

目的:探讨经尿道前列腺电汽化术(TVP)所致电切综合征(TURS)的特点及防治方法。方法:回顾性分析我院1996~2004年施行的2 100例TVP所致27例TURS患者的临床资料,分析术中发生TURS的特点、与手术操作的关系及防治措施。结果:本组27例中,21例均出现不同的TURS症状,出现症状前可伴有血糖升高及低钠血症、中心静脉压升高以及血压波动。术中有22例出现前列腺包膜穿孔(88.2%),经利尿和补充高渗氯化钠溶液等处理后,症状均获改善,未发生死亡。结论:TVP中发生TURS,与操作技术密切相关,严密观察先兆症状及监测血糖、电解质、中心静脉压等,可较早发现TURS。利尿及纠正低钠血症是防治TURS的有效手段。

Clinical feature and the management of transurethral resection syndrome during transurethral electrovaporization of the prostate

Objective:To describe the clinical characters of transurethral resection syndrome(TURS) during transurethral vaporization of the prostate(TVP) and explore its management.Methods:Clinical data of 2100 cases of patients with BPH treated with TVP in our hospital during 1996 through 2004 were reviewed.Results:Among 2100 patients,27 cases were recognized as having TURS((1.28)%),21 cases displayed variant levels of TURS symptoms.PreTURS symptoms included blood glucose increased,serum sodium decreased.CVP(central venous pressure) increased and unstable blood pressure.There were 22 patients had perforation of prostate capsule((80.2)%).TURS symptom improved with using diuretic and sodium solution..No patient died in this group.Conclusions:The occurrence of TURS during TVP was highly related with suigical techniques.It is helpful to keep close watch over pre-TURS symptoms,blood glucose,serum sodium and CVP for early recognization of TURS.Diuretic and correct hyposodium could effectively treat TURS.