【摘要】 目的探讨高渗盐水在预防经尿道电切综合征(TURS)中的作用,提高经尿道前列腺电切术(TURP)的安全性。方法回顾性分析1382例良性前列腺增生(BPH)行TURP临床资料,所有病例常规在电切开始10min后静脉滴注3%氯化钠250ml,如手术时间>60min,可酌情追加3%氯化钠125～250ml。术中静脉输液除输血及胶体溶液外全部采用平衡液。当TURS先兆症状出现时,除使用3%氯化钠外,应及时静脉使用速尿以脱水、10%葡萄糖酸钙以治疗急性心功能紊乱、地塞米松以防止或减轻肺、脑水肿等。结果本组1382例无心衰及经尿道电切综合征(TURS)发生,TURS先兆发生率0.79%。所有病例术后立即复查血生化检查,除38例因多处包膜临界穿孔或静脉窦开放血清钠值偏低外,无一例高钠血症发生。术中输液除胶体溶液外全部采用平衡液对防止稀释性低纳血症也有一定作用。结论TURP术中常规预防性静脉滴注3%氯化钠250～500ml是安全的,能有效防止TURS的发生。更多还原

【Abstract】 Objective To evaluate the effect of hyperosmolality saline on prevention transurethral electroresection syndrome(TURS) and raise reliability of transurethral electroresection of the prostate (TURP). Methods Based on mastering TURP, 1 382 patients were retrospectively studied and diagnosed benign prostatic hyperplasia(BPH). All cases were performed intravenous cannula infusion with 125～250ml 3% hyperosmolality saline after electric ablation began 10 minutes. If operative time was over 60 minutes, 125～250ml 3% hyperosmolality saline were given again. The mainly infusion in operation was equilibrium liquid, besides blood transfusion and colloid liquid. Suitable dose frusemin, 10% calcium glyconate and dexasine were given to prevent complication intraoperation. Results In total 1 382 patients, no heart failure and TURS occurred. The occurrence rate of TURS aura was 0.79%. Serum natrium of 38 patients was lower because of envelope perforation or sinus venosus open. No hypernatremia occurred. Conclusion It is safe that 250～500ml 3% hyperosmolality saline is infused in veins intra TURP, which can effectively prevent occurence of TURS.更多还原