前列腺电汽化切割术中电切综合征防治体会

目的:总结经尿道电汽化前列腺切除术(TUVRP)中电切综合征的诊治经验。方法:单纯汽化切割电极行TUVRP术461例,发生经尿道电切综合征(TURS)32例(6.9%),回顾分析其手术、监护及临床检验资料。结果:32例平均手术时间85min,平均失血270mL,前列腺包膜切破5例(15.6%),手术结束时血清钠为(121.1±4.5)mmol/L,较术前下降(15.3±4.8)mmol/L,P<0.001,差异有显著性。32例均有不同程度呕吐、烦躁、心动过缓等症状,经利尿转好。结论:TUVRP仍有发生TURS的危险,尤其在手术时间长、前列腺包膜切破、术中失血增多时易发生。密切监视血清钠及患者术中的反应,可防止TURS。

TURS during transurethral vapori-resection of the prostate

Objectilve:To summarize the therapeutic experience of TURS during transurethral wapori-resection of the prostate(TUVRP).Methods:Among the consecutive 461 patients who underwent TUVRP,there were 32(6.9%) TURS.The dated of operation,monitor,clinical test of the 32 case were reviewed retrospectively.Results:Of the 32 cases patients,mean operative time was 85 mine,awerage blood loss was 270 mL.The prostatic capsule was perforated in 5 cases(15.6%). At the end of the operation,the serum sodium(121.14.5) mmol/L,declined(15.34.8) mmol/L(P<0.01) respctively.All of 32 cases had one or several transient symptoms,include vomiting,fidgeting,bradycardia,etc. Conclusion:Although TUVRP can decrease fluid absorption,the resk of TURS present still,especially the operation time prolonged,prostatic capsule perforated,blood loss increased.Keep close watch over serum sodium level and patients,TURS be could avoid.