TURP大量灌洗液对老年患者血液流变学影响的研究

The investigation of the change of hemorheology of old patients and its relationship to absorbed irrigating fluid during transurethral resection of prostate

目的：探讨经尿道前列腺电切手术（TURP）中,灌洗液致血液稀释对循环功能及血液流变学的影响.方法：选择ASAⅠ～Ⅱ级32例前列腺增生（BPH）患者,分别于术前（T0）、灌洗12000ml（T1）时、灌洗24000ml（T2）时,采静脉血测血液流变学参数,同时采用多功能监护仪监测平均动脉压（MAP）、心律（HR）、心电图（ECG）、氧饱和度（SpO2）.结果：患者术中循环稳定,在T1、T2时段MAP、SpO2略有升高,心率略有下降,但无显著性差异（P＞0.05）;T1、T2全血粘度、红细胞聚集指数、Hb、Hct较均T0显著降低（P＜0.05）,T1、T2红细胞变形指数较T0升高但无显著性差异（P＞0.05）;T1与T2各项观察指标无显著性差异（P＞0.05）.结论：经尿道前列腺电切术灌洗液灌注,可致一定程度血液稀释,降低血液黏滞性,利于微循环灌注,在一定灌注量范围内对血流动力学影响不大.

Objective： To observe the change of hemorheology and hemodynamics in patients undergoing transurethral resection of prostate and its relationship to absorbed irrigating fluid. Methods： Thirty two patients （ ASA Ⅰ-Ⅱ）for undergoing transurethral resection of prostate were enrolled, blood samples were phlebotomized for measurements of hemorheologic parametes before operation （T0）, after irrigating fluid of 12000ml（T1） and 24000ml （T2）. we also monitored MAP,HR,ECG and SpO2. Results： Hemodynamics were stable during operation, there was significant decrease of the whole blood viscosity, RBC aggregation, HB and HCT at T1 and T2. RBC deformation was increased but not markedly at T1 and T2. Conclusion： Within a certain volume, irrigating fluid during transurethral resection of prostate could maintain hemodynamic stability and improve the hemorheological status and microcirculation perfusion.