Bioz.com在TURP患者血流动力学变化监测及TURS的早期诊治中的应用

Application of Bioz.com in Hemodynamic Monitoring of TURP Patients and Early Diagnosis and Treatment of TURS

目的探讨Bioz.com在经尿道前列腺电切术(TURP)患者中早期诊治电切综合征(TURS)的应用价值。方法选择我院择期行TURP的患者30例,行腰硬联合麻醉,记录患者麻醉前(T_0),麻醉后(T_1),灌洗液量3000 ml(T_2),灌洗液量6000 ml(T_3),灌洗液量9000 ml(T_4),灌洗液量12000 ml(T_5),灌洗液量15000 ml(T_6),灌洗液量18000 ml(T_7)时的心率(HR)、收缩压(SBP)、舒张压(DBP)、搏出量(SV)、体血管阻力(SVR)、胸液成分(TFC)等血流动力学指标以及动脉血Na^+,K^+,Hb,Hct浓度。记录TURS发生情况。结果与T_0时比较,T_1～T_7时:HR升高(P<0.05),其中T_1时升高最明显;SBP与DBP降低(P<0.05),其中T_1时降低最明显;T_2～T_7时:Na^+,Hb,Hct逐渐降低(P<0.05),K^+逐渐升高(P<0.05);SV逐渐升高(P<0.05),SVR逐渐降低(P<0.05),其中T_1时变化最明显;T_2～T_7时,TFC逐渐升高(P<0.05);与T_1时比较,T_2～T_7时:HR逐渐降低(P<0.05);SBP与DBP逐渐升高(P<0.05);Na^+,Hb,Hct逐渐降低,K^+逐渐升高(P<0.05)。SV逐渐升高(P<0.05),SVR逐渐降低(P<0.05),TFC逐渐升高(P<0.05)。直线相关分析示,SV与Na^+呈负相关(r=-0.948,P<0.01),与K^+呈正相关(r=0.969,P<0.01),与Hb呈负相关(r=-0.976,P<0.01),与Hct呈负相关(r=-0.973,P<0.01)。TFC与Na^+呈负相关(r=-0.980,P<0.01),与K^+呈正相关(r=0.996,P<0.01),与Hb呈负相关(r=-0.995,P<0.01),与Hct呈负相关(r=-0.997,P<0.01)。所有患者均未发生TURS。结论应用Bioz.com持续监测血流动力学变化,有助于通过无创的方法来早期预防TURS的发生。

Objective To evaluate the value of Bioz.com in the early diagnosis and treatment of(TURS)in patients with transurethral resection of prostate(TURP).Methods 30 patients with TURP in our hospital were selected and treated with combined spinal-epidural anesthesia.The heart rate(HR),systolic pressure(SBP),diastolic pressure(DBP),stroke volume(SV),body vascular resistance(SVR),hydrothorax component(TFC)and arterial blood Na+,K+,Hb,Hct concentration were recorded before and after anesthesia(T0)and post-anesthesia(T1),lavage fluid volume 3000 ml(T2),lavage fluid 6000 ml(T3),lavage fluid 9000 ml(T4),lavage fluid 12000 ml(T5),lavage fluid 15000 ml(T6),lavage fluid 18000 ml(T7).Record the occurrence of TURS.Results Compared with T0,HR increased during T1~T7(P<0.05),and SBP and DBP decreased most significantly at T1(P<0.05).Na+,Hb,Hct decreased gradually during T2~T7(P<0.05)while K+gradually increased(P<0.05).SV increased gradually(P<0.05),and SVR decreased gradually(P<0.05),the change at T1 was the most obvious.During T2~T7,TFC increased gradually(P<0.05).Compared with T1,HR decreased gradually at T2~T7(P<0.05).SBP and DBP gradually increased(P<0.05);Na+,Hb,Hct decreased,K+gradually increased(P<0.05).SV increased gradually(P<0.05),SVR decreased gradually(P<0.05),TFC gradually increased(P<0.05).Linear correlation analysis showed that SV was negatively correlated with Na+(r=0.948,P<0.01),and positively correlated with K+(r=0.969,P<0.01),negatively correlated with Hb(r=-0.976,P<0.01).negatively correlated with Hct(r=-0.973,P<0.01).TFC was negatively correlated between and Na+(r=0.980,P<0.01),positively correlated with K+(r=0.996,P<0.01),negatively correlated with Hb(r=-0.995,P<0.01),and negatively correlated with Hct(r=0.-997,P<0.01).No TURS occurred in all patients.Conclusion Continuous monitoring of hemodynamic changes with Bioz.com is helpful to prevent the occurrence of TURS in early stage by non-invasive method.