国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2014年
1期
52-55
,共4页
经尿道前列腺切除术%静脉压%中心静脉压%电外科手术
經尿道前列腺切除術%靜脈壓%中心靜脈壓%電外科手術
경뇨도전렬선절제술%정맥압%중심정맥압%전외과수술
Transurethral Resection of Prostate%Venous Pressure%Central Venous Pressure%Electrosurgery
目的 评价肘静脉压(EVP)监测在经尿道前列腺电切术(TURP)中应用的可行性.方法 选择2010年1月～2012年12月哈励逊国际和平医院TURP患者185例,年龄62～ 81岁,前列腺增生Ⅲ°以上,美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级;采用随机数字表法将患者分为中心静脉压组(CVP组,n=92)和肘静脉压组(EVP组,n=93).CVP组行中心静脉穿刺置管,EVP组行肘正中静脉穿刺置管,成功后连续监测CVP和EVP.两组患者如果术中静脉压升高超过3mm Hg,告知外科医生尽快结束手术并调整灌洗液悬挂高度;给予患者静脉注射速尿20 mg并静脉滴注3％高渗氯化钠200 mL;行血气电解质分析并根据分析结果对症处理.记录CVP组和EVP组静脉压变化情况、TURS发生率及血钠情况.采用SPSS19.0软件进行统计学处理及绘图.结果 两组术毕血钠较术前均降低(P＜0.05)但均在正常范围,组间比较差异无统计学意义(P＞0.05);两组均无经尿道前列腺电切综合征(TURS)发生;两组患者静脉压变化趋势一致.结论 TURP术中行肘静脉压监测可以指导优化治疗,减少TURS发生,临床应用可行.
目的 評價肘靜脈壓(EVP)鑑測在經尿道前列腺電切術(TURP)中應用的可行性.方法 選擇2010年1月～2012年12月哈勵遜國際和平醫院TURP患者185例,年齡62～ 81歲,前列腺增生Ⅲ°以上,美國痳醉醫師協會(ASA)分級Ⅰ～Ⅱ級;採用隨機數字錶法將患者分為中心靜脈壓組(CVP組,n=92)和肘靜脈壓組(EVP組,n=93).CVP組行中心靜脈穿刺置管,EVP組行肘正中靜脈穿刺置管,成功後連續鑑測CVP和EVP.兩組患者如果術中靜脈壓升高超過3mm Hg,告知外科醫生儘快結束手術併調整灌洗液懸掛高度;給予患者靜脈註射速尿20 mg併靜脈滴註3％高滲氯化鈉200 mL;行血氣電解質分析併根據分析結果對癥處理.記錄CVP組和EVP組靜脈壓變化情況、TURS髮生率及血鈉情況.採用SPSS19.0軟件進行統計學處理及繪圖.結果 兩組術畢血鈉較術前均降低(P＜0.05)但均在正常範圍,組間比較差異無統計學意義(P＞0.05);兩組均無經尿道前列腺電切綜閤徵(TURS)髮生;兩組患者靜脈壓變化趨勢一緻.結論 TURP術中行肘靜脈壓鑑測可以指導優化治療,減少TURS髮生,臨床應用可行.
목적 평개주정맥압(EVP)감측재경뇨도전렬선전절술(TURP)중응용적가행성.방법 선택2010년1월～2012년12월합려손국제화평의원TURP환자185례,년령62～ 81세,전렬선증생Ⅲ°이상,미국마취의사협회(ASA)분급Ⅰ～Ⅱ급;채용수궤수자표법장환자분위중심정맥압조(CVP조,n=92)화주정맥압조(EVP조,n=93).CVP조행중심정맥천자치관,EVP조행주정중정맥천자치관,성공후련속감측CVP화EVP.량조환자여과술중정맥압승고초과3mm Hg,고지외과의생진쾌결속수술병조정관세액현괘고도;급여환자정맥주사속뇨20 mg병정맥적주3％고삼록화납200 mL;행혈기전해질분석병근거분석결과대증처리.기록CVP조화EVP조정맥압변화정황、TURS발생솔급혈납정황.채용SPSS19.0연건진행통계학처리급회도.결과 량조술필혈납교술전균강저(P＜0.05)단균재정상범위,조간비교차이무통계학의의(P＞0.05);량조균무경뇨도전렬선전절종합정(TURS)발생;량조환자정맥압변화추세일치.결론 TURP술중행주정맥압감측가이지도우화치료,감소TURS발생,림상응용가행.
Objectives To evaluate the feasibility that the elbow venous pressure (EVP) monitoring applied in the transurethral resection(TURP).Methods From January 2010 to December 2012 in Harrison International Peace Hospital,selected 185 cases of TURP patients,aged from 62 to 81 years,benign prostatic hyperplasia Ⅲ degrees,ASA Ⅰ ～ Ⅱ grade.Patients were divided into central venous pressure group(CVP group,n =92) and Elbow vein pressuregroup(EVP group,n =93) using a random number table method.CVP group underwent central venous catheterization and EVP group underwent median cubital vein catheterization,then continuous monitored CVP and EVP after successful puncture.If the patients of the two groups' venous pressure exceeded 3 mmHg intraoperative,informed the surgeon that ended the surgery as soon as possible and adjusted the fluid suspension height.Gave patients furosemide 20 mg intravenous and intravenous infusion of 3％ hypertonic saline 200 ml.Blood gas and electrolyte analysis should be done and then symptomatic treated according the results.Record CVP group and EVP group's venous pressure changes,TURS incidence and sodium circumstances.SPSS19.0 software was used for statistical analysis and graphics.Results The two groups' serum sodium after surgery were lower than the preoperative(P ＜ 0.05)and within the normal range.The difference between groups was not statistically significant(P ＞0.05) ; There were no transurethral resection syndrome (TURS) occurred;The two groups' venous pressure were in the same trend.Conclusions Elbow vein pressuremonitoring in TURP can optimize treatment,reduce TURS occurrence.Clinical application is feasible.
