高渗氯化钠羟乙基淀粉40注射液预防经尿道前列腺电切综合征的临床观察  

Preventive effects of hypertonic sodium chloride hydroxyethyl starch 40 injection on transurethral resection of prostate syndrome

作　　者：郭一闽[1] 王忱[1] 

机构地区：[1]福建医科大学教学医院,福建省厦门市第二医院麻醉科,361021

出　　处：《中国医药》2012年第2期197-199,共3页China Medicine

摘　　要：目的观察高渗氯化钠羟乙基淀粉40注射液用于经尿道前列腺切除术（TURP）的可行性及其预防经尿道前列腺电切综合征的效果。方法选择90例择期行TURP患者，完全随机分为乳酸林格液组（R）、6％羟乙基淀粉组（H）和高渗氯化钠羟乙基淀粉40组（S）。3组均用L3-4腰一硬联合麻醉，麻醉平面控制在T10以下。手术开始后每隔15min记录各时点（To、T15，T30、T45、T60、T75、T90/Tend。）的心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）。每隔30min抽取动脉血检测Na＋、K＋、Hct、Hb，记录手术时间及术中冲洗液用量。结果3组术前HR、MAP、CVP差异无统计学意义（均P〉0．05）。T30之后R组HR、MAP明显下降（P〈0．05），CVP明显升高。T60之后H组HR、MAP明显下降（P〈0．05），CVP明显升高（P〈0．05）。各时点s组HR、MAP、CVP差异无统计学意义（P〉0．05）。3组术前Na＋、K＋、Hot、Hb差异无统计学意义（P〉0．05）。3组各时点K’差异无统计学意义（P〉0．05）。T30之后R组Na＋、Hct、Hb明显下降（P〈0.05）。％之后H组Na＋、Hct、Hb明显下降（P〈0．05），S组Hct、Hb明显下降（P〈0．05）。R组有6例患者发生经尿道前列腺电切综合征，经输入高渗盐水及呋塞米后得到纠正。H组和S组均无一例发生。R组有12例、H组有7例患者发生低血压需要注射麻黄碱纠正，S组无一例发生严重低血压。全部病例均未发生低血钾、过敏反应等不良反应。结论TURP术中应用高渗溶液安全可行，预防经尿道电切综合征的效果较6％羟乙基淀粉优越。Objective To observe the safety of Hypertonic Sodium Chloride Hydroxyethyl Starch 40 Injec tion （HSH） applied in patients undergoing transurethral resection of prostate （TURP） and effects of preventing tran surethral resection syndrome （TURS）. Methods Ninety patients undergoing TURP were divided randomly into 3 groups. Group R patients received sodium lactate ringer＇s injection as control; group H patients had hydroxyethyl starch and sodium chloride injection and groups S patients were administered hypertonic sodium chloride hydroxyeth yl starch 40 injection. Heart rate（ HR）, mean arterial pressure（ MAP）, central venous pressure（CVP） and blood electrolytes were measured and recorded. Results Thirty minutes after the beginning of the operation, HR, MAP, sodium plasma level, hematocrit （Hct） and hemoglobin （Hb） were decreased significantly while CVP were increased significantly in group R patients. 60 minutes after the beginning the operation, the same phenomenon occurred in group H patients. However Hct and Hb were reduced significantly in group S patients. Conclusion Hypertonic So dium Chloride Hydroxyethyl Starch 40 Injection used in TURP patients is safe and feasible, also is more effective than 6% HES to prevent TURS.

关 键 词：经尿道前列腺电切综合征 高渗氯化钠羟乙基淀粉40注射液 血流动力学 

分 类 号：R697[医药卫生—泌尿科学]