【摘要】 目的研究经尿道前列腺电切除术中监测血糖、血钠的临床意义,探讨术中大量冲洗液吸收的途径。方法1300例经尿道前列腺电切除术患者术中用5%葡萄糖液作为冲洗液,手术开始后每30min测血糖一次,通过监测患者术中血糖、血钠的变化,观察冲洗液的吸收途径,电切综合征的发生及手术情况。结果有42例患者血糖均在不同的时间段内短时间迅速升高,9~20mmol/L28例,21~30mmol/L14例,术中发现39例有明显的前列腺包膜裂开、穿孔或膀胱颈部纤维层裂开。随后作快速血电解质测定。4例血钠低于135mmol/L,21例低于125mmol/L,17例低于115mmol/L。与术前血糖、血钠相比差异均有显著统计学意义。结论经尿道前列腺电切除中应用5%葡萄糖溶液作为冲洗液,术中在不同的时间段内短时间血糖迅速升高,说明有冲洗液大量吸收,也表明前列腺包膜裂开、穿孔或膀胱颈纤维层裂开为其主要原因,且与手术操作明显相关。术中血糖升高可作为电切综合征的先兆症状,术中血糖监测有助于早期发现电切综合征。更多还原

【Abstract】 Objective To study the reason of the occurrence of transurethral resection syndrome (TURS) caused by the rinse solution absorption during the operation of transurethral resection of the prostate (TURP). Methods 1300 pations took 5 percent glucose solution as the rinse solution during the operation of TURP. The change of the concentration of sodium and glucose was monitored to analyze the absorption approach of the rinse solution, the occurrence of TURS, the operation status at every 30 minutes after the operation began. Results The glucose concentration of 42 cases rose quickly in short time of the different period of time, that of 28 cases was 9-20mmol/L, that of 14 cases was 21-30mmol/L. During the operation , 39 cases were discovered to have obviously the prostate envelop rupture or perforation , the fibrous layer fission of the bladder neck, then quickly mensurated electrolyte. The natrium concentration of 4 cases lower than 135 mmol/L,that of 21 cases lower than 125 mmol/L, that of 17 cases lower than 115 mmol/L. The concentration of sodium and glucose have a magnificent difference when compare to that of the pre-operation. Conclusion The patients all used 5 percent glucose solution as the rinse solution during the operation of TURP, if the glucose concentration rose quickly in short time of the different period of time, it was testified that a amout of rinse solution was absorbed. It’s main reason was the prostate envelop rupture or perforation ,the fibrous layer fission of the bladder neck.It correlation obviously with the operation skill.The rise of the glucose concentration can be regarded as aura symptom.The montoring of the glucose concentration in the blood is helpful to detect early the TURS during the operation.更多还原