Dimberg M, Allgén L G, Norlén H, Kolmer T
Department of Urology, St. Göran's Hospital, Stockholm, Sweden.
Scand J Urol Nephrol. 1987;21(3):169-76. doi: 10.3109/00365598709180318.
19 patients were studied in connection with transurethral resection of the prostate using the intermittent technique and hypotonic 2.5% sorbitol solution as an irrigating fluid. No diuretics were given postoperatively. In 2 patients there was a slight elevation of the serum creatinine level preoperatively but in 17 patients serum creatinine was within the reference limits. The plasma sorbitol concentration was determined at 20-min intervals for two hours. The mean plasma concentration of sorbitol immediately postoperatively was 379 mg/l (2.1 mmol/l) and the highest level observed was 1,900 mg/l (10.6 mmol/l). The half-life for sorbitol in plasma was 21 min (mean calculated in 11 cases). The range was 11-33 min. With increasing immediate postoperative plasma sorbitol levels there was also an increase in the half-life, corresponding to saturation of the sorbitol metabolizing enzyme system. The absorbed fluid volumes were calculated from the immediate postoperative plasma concentration of sorbitol, which gave a mean of 0.23 1 and a maximum of 1.01. Haemodilution effects with decrease in the serum sodium and serum albumin concentrations were noted, but they were much less marked than when 5% sorbitol solution was used as an irrigating fluid. There were only insignificant increases in the plasma haemoglobin concentrations postoperatively, which were probably due to heat decomposition of red blood cells in the bladder during the operation. About 7% of the absorbed amount of sorbitol was eliminated in the urine (mean). The highest value observed was 18% in the case showing the highest plasma sorbitol concentration immediately postoperatively (1,900 mg/l). Sorbitol was eliminated in the urine over a period of 6 hours postoperatively.
对19例患者采用间歇性技术行经尿道前列腺切除术，并使用低渗2.5%山梨醇溶液作为灌洗液进行研究。术后未给予利尿剂。2例患者术前血清肌酐水平略有升高，但17例患者血清肌酐在参考范围内。在两小时内每隔20分钟测定一次血浆山梨醇浓度。术后即刻血浆山梨醇的平均浓度为379mg/L（2.1mmol/L），观察到的最高水平为1900mg/L（10.6mmol/L）。血浆中山梨醇的半衰期为21分钟（11例计算得出的平均值）。范围为11 - 33分钟。随着术后即刻血浆山梨醇水平的升高，半衰期也增加，这与山梨醇代谢酶系统的饱和相对应。根据术后即刻血浆山梨醇浓度计算吸收的液体量，平均值为0.23L，最大值为1.01L。观察到血清钠和血清白蛋白浓度下降的血液稀释效应，但比使用5%山梨醇溶液作为灌洗液时明显轻得多。术后血浆血红蛋白浓度仅有不显著的升高，这可能是由于手术过程中膀胱内红细胞的热分解所致。约7%（平均）的吸收山梨醇量经尿液排出。术后血浆山梨醇浓度最高（1900mg/L）的病例中观察到的最高值为18%。山梨醇在术后6小时内经尿液排出。
