经尿道前列腺电切术血钠浓度测定与灌注液体内吸收量的估计

Estimation of serum Na level and absorption of irrigating fluid volume in transurethral prostatectomy

本文报告20例经尿道前列腺电切术(TUR—P),术后约有80％有不同程度的低钠血症及灌注液的体内吸收。其中术后血钠等于或低于120.0mmol/L及术中灌注液体内吸收量超过1500ml者共有6例,出现了TUR—P综合征,发生率高达30％。另外发现TUR—P术中血钠降低程度与灌流时间、术中失血量、切除腺体重量及灌注液用量间有明显的正相关性。本文还提出了TUR—P术中减少灌注液的体内吸收,防止血钠下降及预防TUR—P综合征的有效措施。

Transurethral prostatectomy (TURP) may be followed by hyponatremia and hydrotoxicity.In 80% of 20 TURP patients in this series, absorption of the irritating fluid resulted in hyponatremia postoperatively (equal to or lower than 120.0mmol/L) . At least or more than 1500ml of the irrigating fluid was absorbed in 5 cases (25%) . TURP syndrome occurred in 6 cases (30%) . Besides, the degree of serum Na depletion was positively correlated to the irrigating time , volume of blood loss, weight of the resected prostate and the amount of irrigating fluid used. Efficient measures for decreasing the volume of the irrigating fluid absorbed,preventing depletion of serum Na and occurrence of the TURP syndrome were discussed.