单极与双极等离子电切镜在TUEP术中对血钠及心脏负荷的影响

Influence of plasmakinetic bipolar and monopolar vaporized resectoscope in the TUEP to the blood sodium and the heart load

目的:探讨使用单极与双极等离子电切镜在经尿道前列腺剜除术中对术中术后血钠及心脏负荷的影响。方法:选取120例前列腺增生患者分为两组,分别使用单极与双极等离子电切镜在经尿道前列腺剜除术中,每30 min监测血钠、CVP、心率(HR)、MABP,与术前及两组间进行比较,统计分析检验结果。结果:单极组随手术时间的延长血钠浓度降低,有统计学意义(P<0.05),等离子组血钠随手术时间延长变化不明显,无统计学意义,但两组间比较差异有统计学意义(P<0.01);两组患者随手术时间延长CVP均升高,差异有统计学意义(P<0.01),两组间比较差异无统计学意义;HR与MABP两组患者随手术时间的延长无明显变化。结论:单极高频电刀电切镜行TUEP能减少术中冲洗液的吸收、有效预防TURS并发症、减少心脏负荷增加及心衰的发生,可提高手术安全性。

Objective： To explore the influence of plasmakinetic bipolar and monopolar vaporized resectoscope in the TUEP operation to the blood sodium and the heart load. Methods： 120 cases with prostate gland proliferation were divided into two groups,used plasmakinetic bipolar and monopolar vaporized resectoscope for transurethral enucleation of prostate. The blood sodium,CVP,HR,MABP were monitored every half hour,the comparison in front of operation and between two groups was carried out and analyzed. Results：The blood sodium concentration decreased along with the surgery time extension in the single-pole group,with the statistics significance（P〈0.05）. The blood sodium was not obvious change along with the surgery time extension in the plasma group,with the non-statistics significance. The comparison differences between the two group had statistics significance（P〈0.01）. CVP elevated along with the surgery time in two group of patients,the difference had statistics significance（P〈0. 01）,two group of comparison difference showed non-statistics significance. The change of HR and the MABP in the two groups of patients showed not obviously along with the surgery time. Conclusion： Monopolar vaporizedresectoscope for TUEP can reduce the rinse solution absorption of operation, prevents the TURS complication effectively,reduces occurrence of heart load increase and heart failure,enhance the surgery security.