经尿道前列腺电汽化术所致电切综合征的特点及防治

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

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2100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。

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. Pre-TURS 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 （ 80.20% ）. 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.