经尿道前列腺汽化电切术术中静脉滴注3％氯化钠溶液预防稀释性低钠血症

The study on the prevention of diluted hyponatremia by intravenous dripping of 3% sodium chloride solution during transurethral vaporization of the prostate

目的分析经尿道前列腺汽化电切术（TUVP）术中静脉滴注3％氯化钠溶液在预防稀释性低钠血症的作用。方法对85例有明显排尿症状的良性前列腺增生（BPH）患者分成两组行TUVP术，对照组38例术中静脉滴注林格液（3ml／min），浓钠组47例，术中静脉滴注3％氯化钠溶液（2～4ml／min）。手术均采用Wolf电切系统，手术时间均≥60min。术前及术时60min测定血常规和电解质，并对两组所测得的数据进行对照分析。结果浓钠组在术时60min时血钠下降值（1．45±5.14）mmol／L，下降幅度显著低于对照组[下降值（7．79±6．64）mmol／L，P〈0．052。结论TUVP术中静滴3％氯化钠溶液可降低稀释性低钠血症的程度，延缓严重低钠血症的发生，从而降低发生经尿道电切综合征（TURS）的风险。

Objective To analyze the effect of intravenous dripping of 3% sodium chloride solution on prevention of diluted hyponatremia during transurethral vaporization of the prostate （TUVP）. Methods Eighty five cases with benign prostatic hyperplasia （BPH） accompanied with typical lower urinary tract symptoms （LUTS） were divided into two groups during undergoing TUVP operation： the control group（n=38） given Ringer＇s solution dripping （3ml/min） and the concentrated sodium chloride injection group （ n= 47） given 3% sodium chloride solution dripping （ 2-4ml/min）. All of the operations were taken via Wolf electric resection system, and the operation time was ≥60 min. The complete blood count and serum electrolyte were determined before operation and 60 minutes after operation beginning, and the data were compared between the two groups. Results The decrease amplitude of serum sodium was obviously smaller in concentrated sodium chloride injection group（（1.45±5. 14） mmol/L] than that in the control group [（7.79 ± 6.64） mmol/L] 60 minutes after operation beginning （P 〈 0.05 ）. Conclusions Giving 3% sodium chloride solution by intravenous drip during TUVP may reduce the severity of diluted hyponatremia and postpone the occurrence of hyponatremia, and thereby decrease the risk of transurethral resection syndrome .