摘要
目的比较老年病人经尿道前列腺切除术(TURP)中应用两种不同尿道灌注液对内环境的影响。方法42例行TURP术的老年病人,随机分为两组:A组以5%葡萄糖为灌注液(22例),B组以5%甘露醇为灌注液(20例)。分别于术前、灌注45、90min和术毕时,测定血电解质、血糖、血红蛋白(Hb)、红细胞压积(Hct)和CVP。结果随着经尿道灌注液体量的增加及时间的延长,两组血钠、血钾、Hct和Hb均渐降低,其中A组血钠下降幅度明显大于B组而呈低钠血症。A组血糖进行性明显升高(P<0.05,P<0.01),其中2例病人分别高达28和40mmol/L,B组血糖无明显变化。CVP在灌注45和90min时较术前升高(P<0.05),其中A组升高更为明显,至术毕两组均恢复至术前水平。结论TURP术中应用5%甘露醇作灌注液对内环境影响较小,而5%葡萄糖可引起低钠血症和高血糖。
Objective To compare the effects of different perfusate on internal environment in patients undergoing transurethralelectroprostatectomy （TURP）. Methods Forty-two elder patients with benign prostatic hyperplasia undergoing TURP were randomly divided into two groups. The patients in group A（22 patients） received 5%GS as perfusate and those in group B（20 patients） 5% mannitol. Blood electrolytes, blood sugar, hemoglobin（Hb） ,hematocrit（Hct） and central venous pressure（CVP） were measured before surgery, perfusion 45, 90 min and at the end of surgery, respectively. Results Blood potassium, natrium and surgar, Hb and Hct gradually decreased with the increase in perfusion time and amount. Blood natrium in group A decreased to hyponatremia level and was much lower than that in group B. Blood surgar significantly increased in group A and remained unchanged in group B. In two patients of group A,blood surgar was as high as 28 and 40mmool/L, respectively. CVP significantly increased in both groups at perfusion 45 and 90 rain and decreased to the level of before surgery at the end of surgery. The increase extent of CVP in group A was greater than that in group B. Conclusion As perfusate in TURP,5%mannitol has little effect on the organ internal environment and 5 %GS can cause hyponatremia and hyperglycosemia.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第9期674-676,共3页
Journal of Clinical Anesthesiology
关键词
经尿道前列腺切除术
灌注液
机体内环境
Transurethralelectroprostatectomy
Perfusate
Internal environment
