前列腺电汽化切割术中电切综合征防治体会

TURS during transurethral vapori-resection of the prostate

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。

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 （121.1±4.5） mmol/L, declined （15.3±4.8）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.