经尿道前列腺电切术的电切综合症的防治

Prevention and Treatment of TURS Caused by TURP

目的探讨经尿道前列腺电切术(TURP)导致电切综合症(TURS)的原因与防治方法。方法对240例良性前列腺增生(BPH)患者行TURP术,术前对伴有高血压、糖尿病、心律失常等高危患者行充分的内科治疗;术中静脉滴注5%氯化钠溶液,手术时间超过1h者静脉推注速尿;控制手术时间和创面出血,监测血常规和血钠,术后随访1～3个月。结果仅4例发生TURS先兆,无TURS发生,未出现死亡病例。结论在TURP中,采取综合措施防治TURS能取得较好的效果;术中静脉滴注5%氯化钠溶液比静滴林格氏液更有积极意义,应用利尿剂有较好的促进作用。

Objective To explore the cause and the control of transurethral resection syndrome （ TURS ） in transurethral resection of the prostate （TURP）. Methods TURP was performed on 240 cases with benign prostatic hyperplasia（BPH） ; before operation, sufficient internal medical treatment was provided to patients with hypertension,diabetes, arrhythmia; 5 % sodium chloride solution was kept dripping intravenously through out the operation; for those patients with the operation time over 1 hour, intravenous injection of furosemide was performed ; the operation time length and the bleeding of traumatic surface were controlled while the blood routine and serum sodium were monitored ; followup lasted from 1 to 3 months. Result No TURS was found while presymptom of TURS in 4 cases; no death occurred. Conclusions Certain general measurement in controlling TURS in TURP is of good effect; intravenous dripping of 5% sodium chloride solution in operation is superior to that of ringer＇s solution while the application of diuretic is helpful.