不同灌洗液对经尿道前列腺等离子体双极电切术病人血糖、电解质的影响

Effects of different irrigation solution on serum glucose and serum electrolyte in PKRP

目的 :观察经尿道前列腺等离子体双极电切 (PKRP)术中 5 %葡萄糖与 0 .9%生理盐水作为灌洗液对病人血糖、电解质的影响。方法 :5 8例ASAⅠ～Ⅱ级 ,术前无糖尿病 ,肝、肾功能无异常患者。 5 %葡萄糖组 (组Ⅰ ) 2 9例 ;0 .9%生理盐水组 (组Ⅱ ) 2 9例。手术均采用英国佳乐等离子体双极电切系统。结果 :组Ⅰ手术 30、6 0min及术后 6 0min血糖均较术前明显增高 (P <0 .0 1) ,且手术 6 0min较 30min亦明显升高 (P <0 .0 5 )。手术 6 0min及术后 6 0min血钠明显低于基础值 (P <0 .0 1)。血氯无显著性差异。术后 6 0min血钾明显低于基础值 (P <0 .0 5 )。组Ⅱ术中及术后血糖 ,血钾、钠、氯变化无统计学意义 (P >0 .0 5 )。结论 :经尿道前列腺等离子体双极电切术 ,灌洗液选用 0 .9%生理盐水是安全可行的 ,较 5 %葡萄糖注射液更有利于机体内环境的稳定和组织代谢。

Objective:To investigate the effect o f 0.9% sodium chloride and 5% gl ucose as irrigation solution on serum glucose and serum electrolyte in u rethral bipolar plasma kinetic resection of the prostate(PKRP). Methods: 58 patie nts (ASA I,II, without diabetes, normal hepatic and renal function ),were di vided into two groups: groupⅠ, 29 patients irrigated with 5% glucose and groupⅡ, 29 cases with 0.9% sodium chloride. Resul ts:In groupⅠ, serum glucose level increased at 30 and 60 min during operation and 60 min after operation(P<0.01). The level of serum sodium at 60 min d uring operation and 60 min after operation was lower than that before operat ion(P<0.01). Serum chlorine showed no significant difference, however, seru m kali um significantly decreased at 60 min after operation(P<0.05).In group Ⅱ, there was no significant difference of serum glucose, sodium, chlorin e and kalium before operation than those post-operation(P>0.05). Conclusion: 0.9% sodium chlorine injection as irrigation solution in PKRP is safer and more beneficial than 5% glucose injection.