TUR综合征的预防和治疗  

Prevention and treatment of TUR syndrome

作　　者：周孟虎[1] 包明胜 刘林[1] 陈娟[1] 

机构地区：[1]安徽省池州市人民医院麻醉科,247000

出　　处：《临床麻醉学杂志》2009年第4期312-313,共2页Journal of Clinical Anesthesiology

摘　　要：目的总结经尿道前列腺切除(TURP)或汽化电切术(TUVP)中TUR综合征的发生率、诊断和治疗。方法选择TURP、TUVP手术患者378例,分析术中TUR综合征的临床表现、血清Na+、血糖、中心静脉压(CVP)的变化以及治疗方法和预防措施。结果378例中发生TUR综合征8例(2.1%)。其临床表现以胸闷不适、寒战、恶心呕吐、谵妄以及心血管系统症状为主。术后血钠(114.3±5.2)mmol/L,明显低于术前的(142.2±3.2)mmol/L(P<0.01);术后血糖、CVP明显高于术前(P<0.01)。全组均治愈,无后遗症。结论TURP、TUVP术中动态监测CVP有助于早期发现TUR综合征,迅速利尿脱水并补充高张钠是治疗的关键。Objective To summerize the incidence, diagnosis and treatment of transurethral prostate resection syndrome （TURS） in patients undergoing transurethralelectroprostatectomy （TURP） or transurethral electrovaporization of postate（TUVP） surgery. Methods The data of clinical manifestations and the changes of serum natrium, surgar and central venous press ure（CVP） from 378 patients with benign protatic hyperplasis underwent TURP or TUVP surgery were analyzed. Results TURS took place in 8 cases （2.1%） of 378 patients. The patients with TURS clinically manifested chest tightness, chills, nausea, vomiting, delirium and cardiovascular symptoms, in whom serum natrium was significantly lower than that before operation [（114.3±5.2） mmol/L vs. （142.2±3.2） mmol/L] with increased blood sugar and CVP（P〈0.01）. All cases were cured without any complications. Conclusion Dynamically monitoring CVP is helpful in finding TURS in the patients undergoing TURP or TUVP surgery. The key for treating TURS is to use hypertonic solution of natrium and dehydration properly.

关 键 词：TUR综合征 低钠血症 血糖 

分 类 号：R614[医药卫生—麻醉学] R699.8[医药卫生—外科学]