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目的:分析经尿道前列腺切除术(TURP)治疗患者采用预先干预防治前列腺电切综合征(TURS)的效果。方法:55例行择期TURP治疗的患者,随机分为研究组与对照组,其中对照组27例,研究组28例。两组患者皆在麻醉开始半小时内以速度10ml/kg·h输注6%的羟乙基淀粉130/0.4,半小时后,对照组患者采用速度5ml/kg·h输注乳酸格液进行容量维持,研究组也采取同样的液体与方式进行容量维持,但先要以速度5ml/kg·h输注250ml高渗氯化钠羟乙基淀粉进行预先干预后再采用乳酸格液维持容量。术中做好患者心电图、脉搏氧饱和度等的监测,同时膀胱的灌洗液每增加3000毫升时要将两组患者舒张压(DBP)、收缩压(SBP)、心率(HR)等指标记录下来,并进行对比分析;此外,还要将术前(t1)、冲洗液12000毫升(t2)、冲洗液21000毫升(t3)及冲洗液30000毫升(t4)时的血K+、Na+、Ca2+检测出来并记录作对比分析。结果:术中,对照组患者血Na+有明显下降,其中t3、t4与t1时段水平相较有统计学意义(P<0.01),而研究组则无显著性变化(P>0.05);相同时点,两组间血Na+水平相较,差异性显著(P<0.01),有统计学意义。从血流动力学方面来看,两组间的DBP、SBP及HR等皆无明显差异,无统计学意义(P>0.05)。结论:采用TURP手术治疗时,麻醉诱导会引发稀释性血钠下降,若能给予适量高渗氯化钠行预先干预处理,那么则给改善血钠下降幅度,并且对血流动力学影响不大,值得临床借鉴。
Objective: To analyze the effect of TURS in patients undergoing transurethral resection of prostate (TURP). Methods: Fifty-five patients undergoing elective TURP were randomly divided into study group and control group, with 27 cases in control group and 28 cases in study group. In both groups, 6% hydroxyethyl starch 130 / 0.4 was infused within half an hour of the start of anesthesia at a speed of 10 ml / kg · h. After half an hour, the control group was treated with 5 ml / kg · h infusion of lactate solution Capacity maintenance, the team also used the same liquid and the way to maintain capacity, but first to speed 5ml / kg · h infusion of 250ml hypertonic sodium chloride hydroxyethyl starch for the preliminary intervention before using lactate cell maintenance capacity. Intraoperative ECG, pulse oxygen saturation and other monitoring, while the bladder lavage fluid for each additional 3000 ml when the two groups of patients to be diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate (HR) and other indicators of the record (T) and blood plasma K +, Na +, Ca2 + at the time of pretreatment (t1), 12000 ml (t2) of irrigating solution, 21000 ml (t3) of irrigating solution and 30000 ml Come out and record for comparative analysis. Results: The level of Na + in the patients in the control group and the control group was significantly lower than that in the control group (P <0.01), but there was no significant difference in the study group (P> 0.05) Point, there was significant difference (P <0.01) between the two groups in blood Na + level, with statistical significance. From the hemodynamic point of view, there was no significant difference in DBP, SBP and HR between the two groups, with no statistical significance (P> 0.05). CONCLUSIONS: When TURP is used for surgery, the induction of anesthesia will lead to the decrease of dilutional sodium. If pretreatment is given with appropriate amount of hypertonic sodium chloride, then the reduction in serum sodium will be improved and the hemodynamics will not be affected , Worthy of clinical reference.