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目的:探讨经尿道电切术(transurethral resection,TUR)所致电切综合征(TURS)的特点及防治方法。方法:回顾性分析我院1989～2010年施行的2 335例TUR所致63例TURS患者的临床资料,分析术中发生TURS的特点、与手术操作的关系及防治措施。结果:第一阶段经尿道电切手术120例中,发生TURS者14例(11.67%),均为TURP,其中死亡2例;第二阶段经尿道电切手术2 215例,发生TURS者49例(2.21%),无死亡病例。63例均出现不同的TURS症状,出现症状前可伴有血糖升高、低钠血症、中心静脉压升高以及血压波动。术中有24例出现前列腺包膜穿孔(38.1%),经利尿和补充高渗氯化钠溶液等处理后,症状均获改善。结论:TUR中发生TURS与操作技术密切相关,严密观察先兆症状及监测血糖、电解质、中心静脉压等,可较早发现TURS。低压灌注、缩短时间、彻底止血、避免损伤、利尿及纠正低钠血症是防治TURS的有效手段。
Objective: To investigate the characteristics and prevention and cure of TURS caused by transurethral resection (TUR). Methods: A retrospective analysis of clinical data of 63 cases of TURS caused by 2335 TURs performed in our hospital from 1989 to 2010 was conducted. The characteristics of TURS during operation, the relationship with operation and the prevention and cure measures were analyzed. Results: In the first stage of transurethral resection, 14 cases (11.67%) were TURS, all of whom were TURP, of which 2 died. The second stage of transurethral resection of 21 215 cases, TURS occurred in 49 cases (2.21%), no deaths. All 63 patients had different symptoms of TURS. Symptoms were accompanied by hyperglycemia, hyponatremia, central venous pressure and blood pressure fluctuations. There were 24 cases of prostate capsule perforation (38.1%) during surgery, and the symptoms were improved after treatment with diuresis and hypertonic sodium chloride solution. Conclusion: TURS is closely related to the operation technique in TUR. TURS can be detected earlier by closely observing the aura symptoms and monitoring blood glucose, electrolytes and central venous pressure. Low pressure perfusion, shorten the time, complete hemostasis, to avoid injury, diuretic and correct hyponatremia is an effective means of prevention and treatment of TURS.