Tauzin-Fin P
Hôpital Pellegrin-Tondu, Bordeaux.
Therapie. 2002 Jan-Feb;57(1):48-54.
Endoscopic operations in the genitourinary tract require the use of an irrigating fluid containing glycine 1.5% and expose patients to adverse events in relation with the absorption of that irrigating fluid, summarized as "transurethral resection reactions" (TURP syndrome). Intra and extra vascular absorption are now well described. The uptake of 1000 ml of fluid corresponds to an acute decrease in the serum sodium concentration of 5-8 mmol.l-1 and give poor clinical signs. This is the volume above which the risk of absorption-related symptoms is statistically increased. Dilutional hyponatraemia and toxicity of glycine and/or its metabolites explain the clinical symptoms. Hyponatraemia and the osmotic gap assess the diagnosis of TUR syndrome. There is a threat to life and a knowledge of an adequate management is essential. Ethanol monitoring is an non invasive method to prevent and detect early irrigating fluid absorption.
泌尿生殖道的内镜手术需要使用含1.5%甘氨酸的灌洗液,这会使患者面临与该灌洗液吸收相关的不良事件,这些不良事件总结为“经尿道前列腺切除术反应”(TURP综合征)。目前对血管内和血管外吸收已有充分描述。吸收1000毫升液体相当于血清钠浓度急性降低5 - 8 mmol.l-1,且临床症状不明显。这是吸收相关症状风险在统计学上增加的液体量阈值。稀释性低钠血症以及甘氨酸和/或其代谢产物的毒性可解释临床症状。低钠血症和渗透压间隙有助于TUR综合征的诊断。这对生命构成威胁,了解适当的处理方法至关重要。乙醇监测是预防和早期检测灌洗液吸收的一种非侵入性方法。