中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2009年
5期
323-326
,共4页
陈雪君%胡兴云%刘志刚%刘先义
陳雪君%鬍興雲%劉誌剛%劉先義
진설군%호흥운%류지강%류선의
羟乙基淀粉%手术中并发症%经尿道前列腺切除术%胃黏膜
羥乙基澱粉%手術中併髮癥%經尿道前列腺切除術%胃黏膜
간을기정분%수술중병발증%경뇨도전렬선절제술%위점막
Hetasterch%Intraoperative complications%TransuretIlml resection of prostate%Gastric mucosa
目的 探讨高渗氯化钠羟乙基淀粉对预防经尿道前列腺电切术时电切综合征(TURS)发生的作用.方法 将60例行经尿道前列腺电切术患者随机分为两组,各为30例,分别输注高渗氯化钠羟乙基淀粉5 ml/kg(观察组)和乳酸林格溶液(对照组).观察患者血流动力学、电解质水平变化,测定胃黏膜内二氧化碳分压和胃黏膜pH值,记录两组患者TURS发生情况.结果 对照组有4例发生TURS,观察组无一例TURS发生.对照组在手术60 min时血钠为(126.5±13.3)mmol/L、胃黏膜pH值为7.26±0.04,显著低于观察组(P＜0.05),而胃黏膜二氧化碳分压为(54±9)mmHg[(7.2±1.2)kPa],显著高于观察组(P＜0.05).结论 预先输入高渗氯化钠羟乙基淀粉可以改善组织灌注,预防TURS的发生.
目的 探討高滲氯化鈉羥乙基澱粉對預防經尿道前列腺電切術時電切綜閤徵(TURS)髮生的作用.方法 將60例行經尿道前列腺電切術患者隨機分為兩組,各為30例,分彆輸註高滲氯化鈉羥乙基澱粉5 ml/kg(觀察組)和乳痠林格溶液(對照組).觀察患者血流動力學、電解質水平變化,測定胃黏膜內二氧化碳分壓和胃黏膜pH值,記錄兩組患者TURS髮生情況.結果 對照組有4例髮生TURS,觀察組無一例TURS髮生.對照組在手術60 min時血鈉為(126.5±13.3)mmol/L、胃黏膜pH值為7.26±0.04,顯著低于觀察組(P＜0.05),而胃黏膜二氧化碳分壓為(54±9)mmHg[(7.2±1.2)kPa],顯著高于觀察組(P＜0.05).結論 預先輸入高滲氯化鈉羥乙基澱粉可以改善組織灌註,預防TURS的髮生.
목적 탐토고삼록화납간을기정분대예방경뇨도전렬선전절술시전절종합정(TURS)발생적작용.방법 장60례행경뇨도전렬선전절술환자수궤분위량조,각위30례,분별수주고삼록화납간을기정분5 ml/kg(관찰조)화유산림격용액(대조조).관찰환자혈류동역학、전해질수평변화,측정위점막내이양화탄분압화위점막pH치,기록량조환자TURS발생정황.결과 대조조유4례발생TURS,관찰조무일례TURS발생.대조조재수술60 min시혈납위(126.5±13.3)mmol/L、위점막pH치위7.26±0.04,현저저우관찰조(P＜0.05),이위점막이양화탄분압위(54±9)mmHg[(7.2±1.2)kPa],현저고우관찰조(P＜0.05).결론 예선수입고삼록화납간을기정분가이개선조직관주,예방TURS적발생.
Objective To investigate the effects of pre-infusion of hypertonic sodium chloride hydroxyethyl starch 40(HH40)injection in prevention for transurethral electroresection of the prostate syndrome(Tuns).Methods Sixty patients with benign prostate hyperplasia(ASA)grades Ⅱ toⅢwere recruited in the study and randomly divided into two groups,one injected intravenously with HH40 at dose of 5 ml/kg by drip after sursical operation a8 experiment and the other injcoted with the same volume of Ringer's solution as control Mcan arterial pressure,heart rate,saturation of blood oxygen(SaO2)and central venous pressure were monitored for all the patients.In addition.serum concentrations of sodium,potassium,chloride and serum osmolality were determined before(T0)and 30 min(T30)and 60 min(T60) after operation,respectively,as well as pH valRe and partial pressure of carbon dioxide(PgCO2)in the gastric mucosa were determined by a Tonocap monitor.Occurrence of TURS and use of atropine,ephedrine and rinse solution were documented.Resuits TURS occurred in four patients in the eontrol group during surgical operation,whereas uo TUns occurred in experimental group.Serum sodium concentration was (126.5±13.3)mmoL/L at T60 in control group,significantly lower than that in experimental group(P＜0.05),while intragastric pH value and PgC02 level were(7.26±0.04)and(54±9)mm Hg[(7.2±1.2)kPa],respectively in controls,significantly higher than those in experimental group(P＜0.05).Conclusions Pre-infusion with HH 40 can improve tissue perfusion and prevent effectively from TURS in patients with transurethral electroresection of the prostate.
